Among 504 pregnant women, those who used cannabis for mental health reasons had the highest depression scores across all trimesters but showed no faster improvement than those who did not use cannabis.
People interested in cannabis use during pregnancy, particularly for mental health self-medication.
58% of prenatal cannabis users cited mental health as the reason
What the researchers found
Depression, stress, and cannabis use all decreased from first to third trimester. 46.8% reported prenatal cannabis use. Those using cannabis for mental health reasons (58.1% of users) had the highest depression scores at each trimester but their rate of decline was statistically equivalent to non-users, suggesting cannabis was not accelerating symptom improvement.
Why it matters
Many pregnant women report using cannabis specifically to manage depression and stress. This JAMA Network Open study provides direct evidence that this self-medication strategy is not associated with faster symptom improvement, which could inform clinician counseling.
The numbers in context
504 pregnant women. 46.8% reported prenatal cannabis use. 58.1% of users cited mental health reasons. Depression correlated with cannabis use at T1 (r=0.17) and in rate of change (r=0.18). All outcomes declined from T1 to T3.
How the study worked
Prospective cohort study of 504 pregnant women recruited at an academic hospital (2019-2024). Depression (Edinburgh Postnatal Depression Scale), stress (Cohen Perceived Stress Scale), and cannabis use assessed each trimester. Cannabis use motives collected in the first trimester. Linear growth curve models estimated trajectories.
What this study cannot tell us
Observational design cannot prove cannabis fails to help; it may have unmeasured benefits. Self-reported cannabis use may underestimate actual use. Women with the most severe symptoms may be most likely to use cannabis, creating confounding by indication. No randomization possible.
How to read the evidence
Prospective cohort with validated measures and trimester-level data published in JAMA Network Open. Limited by observational design and self-reported cannabis use.
When this study was published
Published in 2024 in JAMA Network Open with data from 2019-2024.
The bigger picture
This study challenges the self-medication rationale that many pregnant cannabis users report. If cannabis is not providing faster depression relief, then the risk-benefit calculation shifts toward recommending evidence-based treatments like therapy or, when appropriate, antidepressants.
Questions still open
- Would providing better access to prenatal mental health treatment reduce cannabis use during pregnancy? Are there subgroups where cannabis does improve prenatal depression? Do prenatal cannabis users switch to other coping strategies as pregnancy progresses?
Common questions
Does cannabis help with depression during pregnancy?
How common is cannabis use during pregnancy?
Read the original research
Cannabis Use and Trajectories of Depression and Stress Across the Prenatal Period.
JAMA network open, 7(12), e2451597
Citation
Constantino-Pettit, Anna; Tillman, Rebecca; Wilson, Jillian; Lashley-Simms, Nicole; Vatan, Naazanene; Atkinson, Azaria; Leverett, Shelby D; Lenze, Shannon; Smyser, Christopher D; Bogdan, Ryan; Rogers, Cynthia; Agrawal, Arpana. (2024). Cannabis Use and Trajectories of Depression and Stress Across the Prenatal Period.. JAMA network open, 7(12), e2451597. https://doi.org/10.1001/jamanetworkopen.2024.51597
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