Perinatal substance use among United States veterans and servicemembers: A scoping review of the literature.

INTRODUCTION: Females are the fastest growing demographic among United States (US) veterans and are increasingly seeking substance use- and gender-specific care through the Veterans Health Administration. Given high risks for adverse maternal and infant outcomes, the perinatal period (i.e., pregnancy and 1-year postpartum) is a critical time for substance use intervention, however, little is known about perinatal substance use among US veterans and servicemembers. METHODS: We conducted a scoping review to summarize existing research on perinatal substance use among US veterans and servicemembers. A systematic search identified 3,534 records, which were screened and reviewed by the research team. RESULTS: Of the 17 articles included, 14 reported prevalence, 10 reported correlates, and 6 reported maternal/obstetric outcomes of perinatal substance use in US veterans or servicemembers. Alcohol and tobacco/cigarette use were overrepresented compared to other substances, and many articles collapsed across substance use categories. Prevalence of alcohol use ranged between 1%-17% and tobacco use ranged between 2-18% during the perinatal period. Perinatal substance use was associated with veteran status, exposure to trauma, and increased likelihood of pre-term delivery and low infant birth weights. CONCLUSIONS: We emphasize the gaps in the literature on perinatal substance use among US veterans and servicemembers. Research was scarce about substances other than alcohol and tobacco, and methodologies varied greatly, making it difficult to infer prevalence and patterns. The absence of intervention or qualitative studies underscores the necessity for research exploring specific needs and treatment preferences of this unique population.