In a nationally representative US sample, pregnant and postpartum women with mood, anxiety, PTSD, or personality disorders had 2 to 12 times higher odds of cannabis use disorder compared to those without these conditions.
Perinatal psychiatrists, obstetricians, maternal mental health researchers
Up to 11.6x higher odds of cannabis use disorder with specific mental health diagnoses
What the researchers found
Among 1,316 pregnant and postpartum women, past-year cannabis use prevalence was 9.8% and cannabis use disorder (CUD) was 3.2%. Women with any past-year mood, anxiety, or PTSD disorder had 2.1 to 3.9 times higher odds of cannabis use, and 2.6 to 10.4 times higher odds of CUD. Specific disorder associations with CUD ranged from 2.4 to 11.6 times higher odds.
Why it matters
The pregnancy and postpartum period is already a time of heightened mental health vulnerability. The strong association between mental health disorders and cannabis use/CUD in this population highlights the need for integrated screening and treatment.
The numbers in context
1,316 women (414 pregnant, 902 postpartum); 9.8% past-year cannabis use; 3.2% CUD; cannabis use aORs: 2.10-3.87 for any mood/anxiety/PTSD; CUD aORs: 2.55-10.44; specific disorder CUD aORs: 2.36-11.60
How the study worked
Analysis of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). Weighted logistic regression models estimated associations between past-year cannabis use, DSM-5 CUD, and DSM-5 mental health disorders among 414 pregnant and 902 postpartum women aged 18-44.
What this study cannot tell us
Cross-sectional data cannot determine whether mental health disorders drive cannabis use or vice versa. Data from 2012-2013 may not reflect current patterns given rapid cannabis legalization. Self-reported cannabis use and psychiatric diagnoses.
How to read the evidence
Nationally representative survey with DSM-5 diagnostic criteria and weighted analyses, though cross-sectional design limits causal inference.
When this study was published
Published 2023 using 2012-2013 data
The bigger picture
As prenatal and postpartum cannabis use increases, the strong comorbidity with mental health disorders suggests that addressing one without the other is likely insufficient.
Questions still open
- Does treating the underlying mental health condition reduce cannabis use during pregnancy? How have these associations changed since further cannabis legalization post-2013?
Common questions
Is cannabis use disorder more common in pregnant women with mental health conditions?
How common is cannabis use during pregnancy and postpartum?
Read the original research
Cannabis use, cannabis use disorder and mental health disorders among pregnant and postpartum women in the US: A nationally representative study.
Drug and alcohol dependence, 248, 109940
Citation
Brown, Qiana L; Shmulewitz, Dvora; Sarvet, Aaron L; Young-Wolff, Kelly C; Howard, Tyriesa; Hasin, Deborah S. (2023). Cannabis use, cannabis use disorder and mental health disorders among pregnant and postpartum women in the US: A nationally representative study.. Drug and alcohol dependence, 248, 109940. https://doi.org/10.1016/j.drugalcdep.2023.109940
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