This study compared maternal substance use during pregnancy between women at ultra-high familial risk for substance use disorders and women selected for an absence of familial risk for alcohol dependence and other substance use disorders. In addition, this study design allowed us to uniquely assess the relative contributions of prenatal exposures to drugs of abuse and a family history of alcoholism on offspring substance use outcomes. Our results indicate that women from families with a high prevalence of substance use disorders are more likely to continue to use and abuse substances during pregnancy. Furthermore, High-Risk offspring who are exposed to alcohol and cigarettes in utero are at especially high risk for early-onset cigarette smoking and substance use disorders. From a public health perspective, it is essential that pregnant women be advised to abstain from both alcohol and cigarettes during pregnancy.
