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Systematic review
Interconnections between unintended pregnancy, alcohol and other drug use, and pregnancy, birth, infant, childhood and socioeconomic outcomes: a scoping review
  1. Kelly A McNamara1,2,
  2. Bridin Murnion1,3,
  3. Penelope Fotheringham2,4,
  4. Mishka Terplan5,
  5. Nicholas Lintzeris1,6,
  6. Ju Lee Oei3,7,
  7. Diana M Bond1,
  8. Natasha Nassar8,
  9. Kirsten I Black1
  1. 1Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  2. 2School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
  3. 3Faculty of Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia
  4. 4MotherSafe Counselling Service, The Royal Hospital for Women, Randwick, New South Wales, Australia
  5. 5Friends Research Institute Inc, Baltimore, Maryland, USA
  6. 6Drug and Alcohol Services, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
  7. 7Department of Newborn Care, The Royal Hospital for Women, Randwick, New South Wales, Australia
  8. 8Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Kelly A McNamara, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2250, Australia; kelly.mcnamara{at}sydney.edu.au

Abstract

Background Unintended pregnancy (UIP) and substance use disorder share underlying root causes with similar impacts for women and their offspring in pregnancy, birth and beyond. Furthermore, intoxication with alcohol and other drugs (AOD) increases the risk of UIP.

Objectives To assess the available evidence on associations between UIP and health, social and economic outcomes, in women who use AOD.

Search strategy The review utilised the Joanna Briggs Institute Methodology for Scoping Reviews and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines. The search was conducted across multiple databases, including Scopus and Medline, and limited to studies published between January 2000 to June 2023.

Selection criteria Studies reporting on interactions between AOD use and UIP, and pregnancy, birth, infant, childhood, social or economic outcomes. All patterns and types of AOD use, except isolated use of tobacco, were included. Studies were available in English and conducted in high-income countries.

Data collection and analysis Selected articles were reviewed, and data collected by two independent reviewers using a standardised data extraction sheet. Findings were summarised and reported descriptively.

Main results A total of 2536 titles and abstracts were screened, 97 full texts were reviewed, and three studies were selected for inclusion in the scoping review. There was heterogeneity in types and patterns of AOD use, differences in study design and tools to assess pregnancy intention, and each focused on disparate outcomes. No study assessed or reported on birth outcomes.

Conclusion There is a paucity of data examining the intersection between AOD use and UIP and further research is needed.

  • Reproductive Health
  • epidemiology

Data availability statement

No data are available.

https://doi.org/10.1136/bmjsrh-2023-202140

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    Data availability statement

    No data are available.

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    Footnotes

    • Contributors KMN: overall content guarantor, substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data, preparation, and review of draft manuscript. BM: substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data, review of draft manuscript. PF Substantial contributions to conception and design, or acquisition of data, review of draft manuscript. MT: substantial contributions to analysis and interpretation of data, review of draft manuscript. NL: substantial contributions to conception and design, review of draft manuscript. JLO: substantial contributions to conception and design, review of draft manuscript. DMB: substantial contributions to acquisition of data, review of draft manuscript. NN: substantial contributions to conception and design, review of draft manuscript. KB: substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data, review of draft manuscript.

    • Funding KMN was supported by The University of Sydney Albert S. McKern Scholarship and NN was supported by Australian National Health and Medical Research Council Fellowship (APP1197940) and Financial Markets Foundation for Children. No other funding sources were utilised for this study. The funder played no role in study design, conducting the research or writing the manuscript.

    • Competing interests NL has received funding for unrelated research projects from Camurus AB, Indivior and the National Health and Medical Research Centre. KMN has received funding from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; however, no funds were directed to this project. No other authors have disclosures of interest.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.