ArticleMaternal and child health journal2019
Prenatal Substance Use and Perceptions of Parent and Partner Use Using the 4P's Plus Screener.
Article in Maternal and child health journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The trial behind it
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Who cites it
6 citing papers in PubMed.
- Evaluating a Multi-Pronged Initiative to Decrease Racial and Ethnic Inequities in the Identification of Maternal Substance Use: Successes, Challenges, and Lessons Learned.Journal of racial and ethnic health disparities · 2026Article
- Partner History of Problematic Substance Use and Self-Reported Substance Use During Early Pregnancy: Findings from Kaiser Permanente Northern California, 2021-2022.Maternal and child health journal · 2025Article
- Evaluating a Multi-pronged Initiative to Decrease Racial and Ethnic Inequities in the Identification of Maternal Substance Use: Successes, Challenges, and Lessons Learned.Research square · 2025Article
- Development of an unannounced standardized patient protocol to evaluate opioid use disorder treatment in pregnancy for American Indian and rural communities.Addiction science & clinical practice · 2021Article
- Marital status, partner acknowledgment of paternity, and neighborhood influences on smoking during first pregnancy: findings across race/ethnicity in linked administrative and census data.Drug and alcohol dependence · 2020Article
- Decreasing smoking during pregnancy: Potential economic benefit of reducing sudden unexpected infant death.Preventive medicine · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
Background Prenatal substance use screening is recommended. The 4 P's Plus screener includes questions on perceived problematic substance use in parents and partner that are not considered in risk stratification. Objectives This research examined the: (1) prevalence of self-reported problematic parental and partner substance use and associations with biochemically-verified prenatal substance use; (2) utility of self-reported perceptions of parent/partner substance use as proxies for prenatal substance use; and (3) degree to which the sensitivity of the 4P's Plus can be augmented with consideration of parent/partner questions in risk stratification. Methods A convenience sample of 500 pregnant women was recruited between January 2017 and January 2018. Participants completed the 4P's Plus and provided urine for drug testing. Diagnostic utility of problematic parent/partner substance use questions was assessed, then compared to the 4P's Plus used as designed, and to the 4P's Plus used with these 2 questions included in risk stratification. Results Half (51%) of respondents reported either partner or parental problematic substance use. When partner or parent problematic substance use were considered as proxies for prenatal substance use, sensitivity was 65% and specificity was 55%. When used as intended, sensitivity was 94% and specificity was 29%. Including partner/parent questions increased sensitivity to 96% but lowered specificity (19%). Partner substance use and combined partner/parent use were associated with prenatal substance use [adjusted odds ratio (aOR): 2.0 (1.2, 2.4; p = 0.006); aOR = 1.6 (1.1, 2.5, p = 0.04)]. Conclusions for Practice Sensitivity of the 4P's Plus may improve with inclusion of self-reported problematic partner/parent substance use items in risk stratification.
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