Determinants of maternal substance use during pregnancy among the pastoral community, Northeast Ethiopia: Bayesian analysis approach

Abstract

Abstract: Consumption of addictive substances during pregnancy has been linked with a range of adverse maternal and child health outcomes. The aim of this study was to assess the rates of prevalence of addictive substance use and determine associated risk factors among pregnant women in pastoral community, Afar Region, Northeast Ethiopia. A community-based cross-sectional study design was employed to recruit a total of 484 pregnant women pastoral community in the Afar Region, Ethiopia. A simple random sampling technique was employed to enroll the eligible pregnant women using the health extension workers’ family logbook as a sampling frame. Bayesian multivariable logistic regression model was employed using adjusted odds ratio with a 95% Bayesian credible interval. The overall prevalence of substance use during pregnancy was 48.1% [95% CI 39%, 62%]. Of these, 37.6% (95% CI: 33.3–42.1%) were khat chewers, 12.2% (95% CI: 9.5–15.4%) were alcohol drinkers, and 12.6% (95% CI: 9.9–15.9%) were cigarette smokers. Maternal younger age tertiary education level, unplanned pregnancy, husband/partner substance use, and household led by a wife only were positively associated but having four or more ANC visits was negatively associated with maternal prenatal substance use. The prevalence of maternal substance use during pregnancy among the pastoral community in the current study setting was relatively higher. Our finding suggests the urgent need for educational campaigns, screening, and targeted interventions for women of childbearing age in the pastoral community of Ethiopia.

Keywords:

• Substance use
• alcohol consumption
• khat chewing
• tobacco use
• pregnancy
• Ethiopia

PUBLIC INTEREST STATEMENT

Substance (alcohol, tobacco, and khat) use during pregnancy remains a serious public health issue since it can have several negative effects on both the mother and the unborn child. In Ethiopia, different banning strategies for cigarette smoking and khat chewing were tried through the implementation varies from region to region. Beyond these efforts made by the government: substance use during pregnancy like alcohol drinking and khat chewing is culturally acceptable in the rural and some pastoral communities of the country.

Although few studies were conducted on maternal substance use in Ethiopia, these studies were not representative of women in the pastoral community, like Afar region. Therefore, this study aimed to determine maternal substance use and its determinants among pregnant women in the pastoral community, Afar region, Northeast Ethiopia. The burden and determinants of substance use during pregnancy are highlighted by the study’s findings, which can assist physicians, policy planners, and decision-makers. The results will also serve as a starting point for future research.

List of abbreviations

ANC	=	Antenatal Care
AOR	=	Adjusted Odds Ratio
CI	=	Credible Interval
EDHS	=	Ethiopian Demographic and Health Survey
LBW	=	Low Birth Weight
MCSE	=	Markov Chain Monte Carlo
PTB	=	Preterm birth
SGA	=	Small for Gestational Age
SD	=	Standard Deviation
WHO	=	World Health Organization

Acknowledgments

We would like to thank Samara University College of Medicine and Health Sciences for its ethical approval. Furthermore, our deepest gratitude goes to the community leaders, participants, data collectors, and supervisors.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

All authors agreed to submit it to the current journal, gave final approval of the version that would be published, contributed significantly to its conception and design, data collection, analysis, and interpretation, participated in its writing or critically revised it for significant intellectual content, and agreed to be fully responsible for all aspects of the work.

Availability of data and materials

All materials and data related to this article are included in the main document of the manuscript. However, if anyone is interested to have raw data, he/she can contact the corresponding author.

Ethical issues and consent to participate

Ethical clearance was obtained from the Ethical Review Committee of the College of Medicine and Health Sciences (CMHS), Samara University (CMHS/0311/2021. The ethical approval letter was submitted to the concerned bodies. Oral informed consent was obtained from the patients before enrolment. Privacy and confidentiality were kept.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Setognal Birara Aychiluhm

Setognal Birara Aychiluhm graduated from University of Gondar with a Master of Public Health (MPH) in Biostatistics. Currently, he is an Assistant Professor of Biostatistics in the Department of Public Health, College of Medicine and Health Sciences, Samara University, Ethiopia. He is a coordinator of the Publication and Editorial Office of the University.

His areas of interest in study include infectious and non-infectious diseases, biostatistical models, maternal, neonatal, and child health.