In a database of over 2 million pregnant patients, those who used cannabis had 2.7 times higher rates of depression, 5.5 times higher panic disorder, 10.7 times higher suicidal ideation, and 13.6 times higher alcohol abuse compared to non-users.
Pregnant individuals, healthcare providers, and anyone interested in prenatal cannabis use and maternal mental health.
29.7% of pregnant cannabis users had depression vs 11.2% of non-users
What the researchers found
Cannabis use during pregnancy was associated with significantly elevated risks across all four mental health outcomes: depression (RR 2.66), panic disorder (RR 5.47), suicidal ideation (RR 10.67), and alcohol abuse (RR 13.57). Depression affected 29.7% of cannabis users versus 11.2% of non-users. All differences were highly significant (p < 0.001).
Why it matters
Cannabis use during pregnancy has risen alongside legalization and perceived safety. These dramatic risk ratios for depression, panic, suicidal ideation, and alcohol abuse underscore that prenatal cannabis use may be a marker for, or contributor to, serious maternal mental health challenges that affect both mother and child.
The numbers in context
Sample: 51,087 cannabis users vs 1,936,508 non-users during pregnancy from 69 HCOs. Depression: 29.7% vs 11.2% (RR 2.66, HR 3.50). Panic disorder: RR 5.47, HR 5.01. Suicidal ideation: RR 10.67, HR 9.81. Alcohol abuse: RR 13.57, HR 12.44.
How the study worked
Retrospective cohort study using the TriNetX database, including over 2 million pregnant patients from 69 US healthcare organizations. A cohort of 51,087 cannabis users during pregnancy was compared to 1,936,508 non-users. Outcomes were identified using ICD-10 codes. Risk ratios, hazard ratios, and Kaplan-Meier survival analyses were calculated.
What this study cannot tell us
Retrospective database study using ICD-10 codes, which may undercount both cannabis use and mental health diagnoses. No causal conclusions can be drawn: cannabis use during pregnancy likely correlates with many unmeasured social and psychological risk factors. No propensity matching or adjustment for confounders was described in the abstract.
How to read the evidence
Very large retrospective cohort (2 million patients) from a national database, but limited by ICD-10 code reliance and unclear confounding adjustment.
When this study was published
Published in 2025.
The bigger picture
The very high risk ratios for suicidal ideation and alcohol abuse likely reflect that prenatal cannabis use is a marker for broader substance use and mental health vulnerability, not necessarily that cannabis directly causes these outcomes. The association with alcohol abuse (RR 13.57) particularly suggests polysubstance patterns. Still, these numbers highlight the importance of screening and support.
Questions still open
- How much of the elevated risk is directly attributable to cannabis versus underlying vulnerability and polysubstance use? Would these associations hold after adjusting for socioeconomic factors, prior mental health history, and other substance use? Does the dose or frequency of cannabis use matter?
Common questions
Does cannabis cause these mental health problems during pregnancy?
Why was the alcohol abuse association so high?
How common was cannabis use during pregnancy?
Read the original research
Cannabis Use During Pregnancy Correlates With Adverse Maternal Mental Health Outcomes: A Retrospective Study.
Cureus, 17(4), e82146
Citation
Dereschuk, Kypros J; Espiridion, Eduardo. (2025). Cannabis Use During Pregnancy Correlates With Adverse Maternal Mental Health Outcomes: A Retrospective Study.. Cureus, 17(4), e82146. https://doi.org/10.7759/cureus.82146
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