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Drug abuse can occur at any stage in a woman's life. Of women who use illicit drugs, however, about half are in the childbearing age group of 15 to 44. In 1992/1993, NIDA conducted a nationwide hospital survey to determine the extent of drug abuse among pregnant women in the United States. This National Pregnancy and Health Survey* still provides the most recent national data available.

The survey found that of the 4 million women who gave birth during the period, 757,000 women drank alcohol products and 820,000 women smoked cigarettes during their pregnancies. There was a strong link among cigarette, alcohol, and illegal drug use. Thirty-two percent of those who reported use of one drug also smoked cigarettes and drank alcohol.

Survey results showed that 221,000 women used illegal drugs during their pregnancies that year, with marijuana and cocaine being the most prevalent: 119,000 women reported use of marijuana and 45,000 reported use of cocaine. The survey estimated that the number of babies born to these women was 222,000, a close parallel to the number of mothers. Generally, rates of any illegal drug use were higher in women who were not married, had less than 16 years of formal education, were not working, and relied on some public source of funding to pay for their hospital stay.

Despite a generally decreasing trend in the use of drugs from 3 months before pregnancy and through the pregnancy, women did not discontinue drug use. However, findings from other NIDA research on women in treatment, for example, indicate that once women are successfully detoxified and enrolled in a treatment program, their motivator to stay drug free is their children.

The survey also pointed to issues of prevalence differences among ethnic groups. While the rates of illegal substance abuse were higher for African Americans, the estimated number of white women using drugs during pregnancy was larger at 113,000 than the number of African-American women at 75,000, or Hispanic women at 28,000.

As for the legal drugs, estimates of alcohol use were also highest among white women at about 588,000, compared to 105,000 among African-American women, and 54,000 among Hispanic women. Whites had the highest rates of cigarette use as well: 632,000 compared with 132,000 for African Americans and 36,000 for Hispanics.

Rates of marijuana use were highest among those under 25 and rates of cocaine use were higher among those 25 and older.