114 - Pre-pregnancy depression, prenatal care, and e-cigarette/cigarette use during late pregnancy among adolescents

Publication Number: 114.6532

XIAOZHONG WEN, State University of New York at Buffalo, Buffalo, NY, United States

Background: Little is known about the impacts of depression on e-cigarette use among pregnant adolescents.

Objective: We aimed to examine 1) the association between pre-pregnancy depression and e-cigarette/cigarette use during late pregnancy among adolescents, and 2) whether the frequency of prenatal care visits could moderate this association.

Design/Methods: We used data from 10,044 adolescents (aged 10-19) enrolled in the U.S. Pregnancy Risk Assessment Monitoring System from 2016-2021. Postpartum adolescents reported their e-cigarette and cigarette use in the last 3 months of pregnancy, which was used to define exclusive e-cigarette use, exclusive cigarette use, and dual use. They also reported their depression status before pregnancy. We used multivariable logistic regression models to estimate 1) the associations of depression with e-cigarette/cigarette use and 2) the interaction between depression and the number of prenatal care visits, adjusting for socio-demographic and pregnancy-related confounders.

Results: Pregnant adolescents with pre-pregnancy depression were as likely to use e-cigarettes exclusively during late pregnancy as pregnant adolescents without pre-pregnancy depression (3.21% vs. 1.66%; confounder-adjusted odds ratio [AOR], 1.33 [95% confidence interval or CI, 0.78-2.27]). However, those with pre-pregnancy depression were more likely to use cigarettes exclusively (12.72% vs. 4.81%; AOR, 1.94 [95% CI, 1.44-2.61]) or dual use both e-cigarettes and cigarettes (3.50% vs. 0.59%; AOR, 4.62 [95% CI, 2.18-9.81]) during late pregnancy. The association between pre-pregnancy depression and exclusive cigarette use was weaker (interaction p-values < 0.05) among adolescents with 9-11 prenatal care visits (AOR, 1.38 [95% CI, 0.82-2.32]) or ≥12 prenatal care visits (AOR, 1.77 [95% CI, 1.10-2.84]), compared to those with ≤8 prenatal care visits (AOR, 3.86 [95% CI, 2.23-6.67]).

Conclusion(s): Pre-pregnancy depression was associated with cigarette use or dual use of e-cigarettes and cigarettes among pregnant adolescents, but not with exclusive use of e-cigarettes. Frequent prenatal care may help to mitigate the elevated risk of cigarette use associated with pre-pregnancy depression.