Prenatal substance use during the Covid-19 pandemic in the United Kingdom

Associations with depression, anxiety, and pandemic stressors

Bibliographic Data

ID22067167
AuthorsSwarali Datye (University of Augsburg), Eva M J Peters (0000-0003-2423-527X, Justus-Liebig-Universität Gießen), Anita C Windhorst (Justus-Liebig-Universität Gießen), Anita Windhorst (0000-0002-7357-2080, Justus-Liebig-Universität Gießen), Edwin Van Teijlingen (0000-0001-5523-8583, Bournemouth University), Alison MacRae-Miller (University of British Columbia), Latha Vinayakarao (0000-0003-1830-7812, University Hospitals Dorset NHS Foundation Trust), Minesh Khashu (0000-0003-2673-5948, University Hospitals Dorset NHS Foundation Trust), Fabian B Fahlbusch (0000-0001-5480-0204, University of Augsburg), Melanie L Conrad (0000-0002-8811-5536, University of Augsburg)
Year2026
Volume14
Pages1760266-1760266
Publication date2026-03-19
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2026.1760266
PMID41938932
OpenAlexW7138877218
LanguageEN
References cited54

Introduction: The COVID-19 pandemic was associated with high levels of depression and anxiety among pregnant individuals in the UK, as shown previously in the EPPOCH cohort. However, the relationships between these psychological burdens, pandemic-related stressors, and substance use in the prenatal period have not been systematically investigated. Methods: = 3,292; June-November 2020). Participants reported alcohol, tobacco, cannabis, and illicit drug use before and after recognition of pregnancy, alongside validated measures of depression, anxiety, pregnancy-related anxiety, and pandemic stressors. Linear regression models examined associations between mental health, COVID-19 stressors, and substance use after pregnancy recognition. A qualitative thematic analysis of 380 open-ended responses explored perceptions of substance use post-pregnancy recognition. Results: Alcohol was the most commonly used substance before pregnancy. Following pregnancy recognition, tobacco (8.75%), and alcohol (8.60%) were the most frequently reported substances, followed by cannabis (1.49%) and illicit drugs (0.12%). Tobacco use after pregnancy recognition was associated with higher levels of depressive symptoms and pandemic stressors, including perceived personal health threat and not receiving necessary care. Prenatal co-use of substances was associated with higher depressive symptoms and pandemic-related financial difficulties. Qualitative themes included continued substance use until pregnancy detection, vaping as a perceived safer-use strategy, and midwifery advice influencing prenatal substance use decisions. Discussion: In this large UK pregnancy cohort recruited during the COVID-19 pandemic, substance use following pregnancy recognition-particularly tobacco-was linked to depression and pandemic-related stressors. These findings highlight the importance of equipping midwives and other healthcare professionals with clear, evidence-based guidance on prenatal substance use, particularly during global health crises

Anxiety · Cannabis · Mental health · Pandemic · Pregnancy · Prenatal care · Substance use · Thematic analysis · COVID-19 Impact on Reproduction · Maternal Mental Health During Pregnancy and Postpartum · Prenatal Substance Exposure Effects

Tools

Open DOIOpen Access