TOPLINE:
Among 504 pregnant individuals, 46.8% reported using cannabis during pregnancy, with 58.1% citing mental health reasons. Cannabis use did not accelerate improvement in depression or stress symptoms compared with nonusers, even among those specifically using it for mental health relief.
METHODOLOGY:
- A cohort study recruited 504 pregnant individuals (median age, 26 years; range, 18-40 years) at an academic hospital’s obstetric clinic between July 2019 and January 2024, including those with lifetime cannabis use history.
- Researchers measured depression using Edinburgh Postnatal Depression Scale, stress using Cohen Perceived Stress Scale, and self-reported cannabis use at each trimester, along with motives for use during first trimester.
- Analysis included individual linear growth curve models to estimate changes in depression and stress scores and categorical self-reported prenatal cannabis use from first to third trimester.
- Participants reporting heavy episodic alcohol use or other illicit drug use were excluded from the study.
TAKEAWAY:
- Depression and prenatal cannabis use showed positive correlations at first trimester (correlation coefficient [r], 0.17; P = .004) and in their rate of change (r, 0.18; P = .01), while stress and cannabis use were only correlated at first trimester (r, 0.14; P = .004).
- Participants using cannabis for mental health reasons (58.1%) demonstrated higher depression scores at each trimester, with more than twice the odds of continued use into second trimester compared with other users (odds ratio [OR], 2.77; 95% CI, 1.41-5.44; P = .003).
- Depression, stress, and cannabis use all decreased from first to third trimester (all slope estimates < −0.29; standard error, 0.23-0.7; P < .001).
- According to the researchers, individuals using cannabis for mental health reasons did not experience faster reduction in their symptoms than nonusers.
IN PRACTICE:
“Many studies on cannabis use during pregnancy focus on the impact of this prenatal exposure on fetal growth and offspring outcomes. Greater emphasis is needed on maternal prenatal well-being. Beyond the heightened risk of prolonged in utero exposure to their offspring, our study urges attentiveness to cannabis use in individuals experiencing mental health symptoms and calls for increased access to empirically supported and effective alternatives to cannabis during pregnancy in individuals with prenatal depression, particularly in those who report coping as a motive for their use.”
SOURCE:
The study was led by Anna Constantino-Pettit, PhD, Department of Psychiatry, Washington University in St. Louis, School of Medicine in St. Louis, Missouri. It was published online on December 17 in JAMA Network Open.
LIMITATIONS:
The study was limited by having only three measurement time points during pregnancy, which restricted the ability to test for nonlinear slopes in the analysis. Additionally, the numbers of individuals in groups stratified by use motives may have limited statistical power to detect potential differences in slopes. The researchers noted that ongoing postpartum data collection may allow for alternative models in the future.
DISCLOSURES:
The study was supported by grant 5ROIDAO46224 from the National Institute on Drug Abuse and grant 5T32MH100019 from the National Institute of Mental Health. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.