Analysis of 3,373 pregnant women found those experiencing serious psychological distress used cannabis nearly three times as many days per month compared to those without distress.
Obstetricians, maternal mental health providers, prenatal substance use researchers
Serious psychological distress associated with 2.9x more cannabis use days during pregnancy
What the researchers found
Among 3,373 pregnant women aged 18-44, approximately 6% experienced serious psychological distress in the past 30 days. Compared to those without SPD, pregnant women with SPD showed significantly higher rates of cigarette smoking (IRR=2.1), binge drinking days (IRR=5.1), and cannabis use days (IRR=2.9). All associations remained significant after adjusting for covariates.
Why it matters
The strong link between psychological distress and prenatal substance use suggests that treating maternal mental health could reduce substance exposure during pregnancy more effectively than substance-specific interventions alone.
The numbers in context
3,373 pregnant women; 6% experienced SPD; cannabis use days IRR=2.9 (95% CI 1.3-6.5); cigarettes IRR=2.1 (95% CI 1.1-4.5); binge drinking days IRR=5.1 (95% CI 1.7-15.4)
How the study worked
Descriptive and negative binomial regression analyses of the 2015-2019 National Survey on Drug Use and Health (NSDUH). Examined associations between serious psychological distress and quantity/frequency of tobacco, alcohol, and cannabis use among 3,373 pregnant women aged 18-44.
What this study cannot tell us
Cross-sectional NSDUH data cannot establish causation. Self-reported substance use likely underestimates true use during pregnancy. SPD is a screening measure, not a clinical diagnosis. Cannot distinguish between types of psychological distress.
How to read the evidence
Large nationally representative survey with adjusted regression models, though cross-sectional design and self-reported data have inherent limitations.
When this study was published
Published 2023 using 2015-2019 data
The bigger picture
When pregnant women use substances at higher rates during psychological distress, interventions that only target substance use without addressing the underlying mental health need may miss the primary driver.
Questions still open
- Would treating maternal depression and anxiety reduce prenatal cannabis use as a secondary effect? Are women using cannabis specifically to self-medicate psychological distress during pregnancy?
Common questions
Does mental health affect cannabis use during pregnancy?
How common is psychological distress among pregnant women?
Read the original research
Exploring the associations between serious psychological distress and the quantity or frequency of tobacco, alcohol, and cannabis use among pregnant women in the United States.
Preventive medicine, 177, 107770
Citation
David, Ayomide T; Sharma, Vinita; Bittencourt, Lorna; Gurka, Kelly K; Perez-Carreño, Juan Guillermo; Lopez-Quintero, Catalina. (2023). Exploring the associations between serious psychological distress and the quantity or frequency of tobacco, alcohol, and cannabis use among pregnant women in the United States.. Preventive medicine, 177, 107770. https://doi.org/10.1016/j.ypmed.2023.107770
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