Prevalence of tobacco and alcohol use among pregnant women in India: a systematic review and meta-analysis

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Background Substance use during pregnancy, particularly tobacco and alcohol, is a global concern, including in India. This study assessed their prevalence during pregnancy in India and identified contributing factors.Methods PubMed, Embase, and Scopus were searched to find relevant studies published between 2000 and June 2023. Inclusion criteria comprised studies reporting tobacco or alcohol use prevalence during pregnancy in India. Quality assessment and data extraction were performed independently by two reviewers. Pooled prevalence was determined using R software with a random-effects model.Results The pooled prevalence of tobacco use among pregnant women in India, based on analysis of 7 studies with 69,552 participants, was 8.4% (95% CI: 5.6; 12.3). For alcohol use, analysis of 3 studies involving 755 participants revealed a pooled prevalence of 20.9% (95% CI: 8.7; 42.3). Furthermore, specific demographic subgroups with a higher likelihood of tobacco use were identified, including pregnant women aged ≥ 25 years, those with limited awareness regarding tobacco’s adverse health effects, and those whose close contacts engaged in tobacco consumption.Conclusion Tobacco and alcohol use during pregnancy are prevalent in India. Developing effective strategies to reduce these rates is important for achieving sustainable development goals (SDGs) and improving maternal and child health.