The authors sought to determine whether pregnancy is an intrinsic motivator for cessation of drug abuse.

The authors conducted prospective cohort, co-relative, co-spouse, and within-person analyses of registration for drug abuse during pregnancy among Swedish women born between 1980 and 1990 who gave birth between ages 20 and 35 (N=149,512). Drug abuse was assessed from medical, criminal, and pharmacy registries.

In the population, rates of drug abuse were lower during pregnancy (unadjusted odds ratio=0.67, 95% CI=0.60, 0.74). Compared with population results, the negative association between pregnancy and drug abuse was moderately stronger in cousins (odds ratio=0.49, 95% CI=0.39, 0.62) and substantially stronger in siblings (odds ratio=0.35, 95% CI=0.24, 0.51) discordant for pregnancy. The estimated odds ratio for drug abuse in pregnancy-discordant monozygotic twins was even stronger, at 0.17 (95% CI=0.10, 0.31). Within individuals, the odds ratio for drug abuse while pregnant compared with an equivalent prepregnancy interval was similar to that seen in pregnancy-discordant monozygotic twins, at 0.22 (95% CI=0.19, 0.26). Compared with cohabiting fathers, mothers had a greater reduction in risk for drug abuse during pregnancy (odds ratio=0.40, 95% CI=0.34, 0.47). Pregnancy was more protective in women with low parental education and without a cohabiting, actively drug-abusing father. Compared with prepregnancy baseline, within-individual analyses indicate that risk for drug abuse is also substantially reduced in the postpartum period, for example, the odds ratio for postpartum days 0–242 was 0.13 (95% CI=0.11, 0.16).

Risk for drug abuse in women is substantially reduced during pregnancy. Multiple analyses suggest that this association is largely causal, suggesting that pregnancy is indeed a strong intrinsic motivator for drug abuse cessation. Similar strong protective effects may be present in the immediate postpartum period. Our results have implications for our etiologic models of drug abuse and especially for contingency management programs seeking to reduce drug abuse risk.

作者试图确定怀孕是否是戒毒的内在诱因。

作者对1980年至1990年之间出生，年龄在20至35岁之间的瑞典妇女进行了前瞻性队列研究，同居，同居和个人内部分析，以了解怀孕期间的药物滥用登记情况（N = 149,512）。从医疗，刑事和药房登记处评估了药物滥用情况。

在人群中，怀孕期间的药物滥用率较低（未调整的优势比= 0.67，95％CI = 0.60，0.74）。与总体结果相比，表亲的怀孕和药物滥用之间的负相关性中等偏强（几率= 0.49，95％CI = 0.39，0.62），而兄弟姐妹则显着更强（几率= 0.35，95％CI = 0.24，0.51）。 ）不适合怀孕。妊娠不一致的单卵双胞胎中药物滥用的估计优势比甚至更高，为0.17（95％CI = 0.10，0.31）。在个体中，与同等的怀孕间隔相比，怀孕期间药物滥用的几率比与妊娠期不一致的单卵双胎中所见的相似，为0.22（95％CI = 0.19，0.26）。与同居父亲相比，母亲在怀孕期间吸毒的风险降低幅度更大（优势比= 0.40，95％CI = 0.34，0.47）。父母教育程度低，没有同居，积极吸毒的父亲，怀孕对妇女更具保护作用。与怀孕前的基线相比，个人内部分析表明，产后期间药物滥用的风险也大大降低，例如，产后0-242天的比值比为0.13（95％CI = 0.11，0.16）。

妇女在怀孕期间滥用药物的风险大大降低。多种分析表明，这种关联在很大程度上是因果关系，表明怀孕确实是戒毒的强大内在动机。在产后立即可能会有类似的强保护作用。我们的结果对我们的药物滥用的病因学模型，特别是对寻求减少药物滥用风险的应急管理计划具有影响。