Among over 6,000 women from five US states, stressful life events like a partner going to jail or losing a job were associated with higher odds of cannabis use before, during, and after pregnancy.
Prenatal care providers, social workers, and pregnant women.
36.4% of pre-pregnancy users continued during pregnancy
What the researchers found
16.4% of respondents used cannabis pre-pregnancy, with 36.4% continuing during pregnancy. Among those who quit during pregnancy, 23.2% relapsed postpartum. Nine of 14 stressful life events were associated with pre-pregnancy use (e.g., partner/mother jailed: aOR 2.16). Four events predicted continued use during pregnancy (e.g., partner lost job: aOR 2.19). Postpartum relapse was linked to partner saying they did not want the pregnancy (aOR 2.86).
Why it matters
Understanding that stress drives perinatal cannabis use suggests that addressing stressors could be more effective than simply telling women to stop using cannabis during pregnancy.
The numbers in context
6,061 women across 5 states. 16.4% pre-pregnancy use. 36.4% continued during pregnancy. 23.2% postpartum relapse. Partner jailed: aOR 2.16. Partner lost job: aOR 2.19. Partner did not want pregnancy: aOR 2.86 for postpartum relapse.
How the study worked
Cross-sectional analysis of PRAMS 2016 data from five US states (Alaska, Colorado, Maine, Michigan, Washington). Logistic regression adjusted for demographics, geography, and cigarette smoking among 6,061 women who delivered a live infant.
What this study cannot tell us
Cross-sectional design. Self-reported cannabis use (likely underreported). Five states may not represent the whole US. Cannot establish causation between stress and cannabis use.
How to read the evidence
Large population-based survey with robust statistical methods, but cross-sectional and self-reported.
When this study was published
2020 analysis of 2016 PRAMS data.
The bigger picture
The finding that interpersonal stressors (partner incarceration, unwanted pregnancy) are key drivers suggests cannabis use during pregnancy may be a coping mechanism for relationship and social stress.
Questions still open
- Would stress reduction interventions during pregnancy reduce cannabis use? Are women using cannabis specifically to cope with these stressors?
Common questions
How common is cannabis use during pregnancy?
What predicts cannabis use in pregnancy?
Read the original research
Cannabis use and stressful life events during the perinatal period: cross-sectional results from Pregnancy Risk Assessment Monitoring System (PRAMS) data, 2016.
Addiction (Abingdon, England), 115(9), 1707-1716
Citation
Allen, Alicia M; Jung, Alesia M; Alexander, Adam C; Allen, Sharon S; Ward, Kenneth D; al'Absi, Mustafa. (2020). Cannabis use and stressful life events during the perinatal period: cross-sectional results from Pregnancy Risk Assessment Monitoring System (PRAMS) data, 2016.. Addiction (Abingdon, England), 115(9), 1707-1716. https://doi.org/10.1111/add.15003
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