Does Prenatal Exposure to Alcohol and Cigarette Smoking Increase Risk of Hospitalization for American Indian Infants

Background: Prenatal exposure to alcohol and tobacco are both associated with increased risk for adverse outcomes. American Indians experience disproportionate rates of adverse birth outcomes. The Indian people living in the Great Plains Area of the Indian Health Services have increased exposure to alcohol and smoking during pregnancy. This study aims to assess the relationship between prenatal alcohol and tobacco exposure and early hospitalization in a rural Tribal Nation. Methods: We used data from the prospective Safe Passage Study on pregnancies and hospitalizations within the first year of life. The relationship between time to hospitalization and prenatal tobacco/alcohol exposure, maternal demographics, post-traumatic stress disorder and depression were evaluated. The analysis utilized Chi-square tests. Kaplan-Meier curves were used to estimate the likelihood of hospitalization during the first year of life by substance use category. Results: From a sample of 432 infants, we identified 260 (60.2%) who had a hospitalization. We found no significant effect from that if mother drank, amount drank, amount smoked or if mother smoked, on the risk of hospitalization. We did identify an effect for exposure to alcohol or smoking and age to hospitalization. Exposure was associated with younger age at hospitalization. However, after controlling for mother’s age, this effect was not significant. Mother’s age was significant in all models of hospitalization risk from parental exposure. Discussion: Reducing prenatal exposure to tobacco and alcohol may decrease hospitalization rates for infants from this Tribal Nation, especially among young mothers.