Violence and substance use among North Carolina pregnant women.

OBJECTIVES: Prenatal patients were studied to examine the proportion of women who had been violence victims, women's patterns of substance use (cigarettes, alcohol, and illegal drugs) before and during pregnancy, and relationships between violence and substance use. METHODS: More than 2000 prenatal patients in North Carolina were screened for violence and substance use. Relationships between violence and patterns of substance use before and during pregnancy were examined, as well as women's continuation of substance use during pregnancy as a function of violence and sociodemographic factors. RESULTS: Twenty-six percent of the women had been violence victims during their lives. Before pregnancy, 62% of the women had used one or more substances; during pregnancy, 31% had used one or more substances. Both before and during pregnancy, violence victims were significantly more likely to use multiple substances than nonvictims. Continuation of substance use during pregnancy was significantly more likely among violence victims than nonvictims. CONCLUSIONS: Care providers should screen women for violence as well as for substance use and should ensure that women are provided with appropriate interventions.