Prenatal cannabis use raised postpartum depression risk by 60%, with higher risk for those with depression history | Research

The takeaway

Among 799 low-income pregnant patients, prenatal cannabis users were 60% more likely to screen positive for postpartum depression, with the risk even higher (62%) for those with a pre-existing depression history.

Obstetricians, maternal mental health clinicians, and perinatal substance use counselors

60% higher PPD risk in prenatal cannabis users (aRR 1.60)

What the researchers found

Among 799 patients, 15.9% used cannabis during pregnancy. Prenatal cannabis users had 60% higher risk of screening positive for PPD (aRR 1.60, 95% CI 1.05-2.45). Among those with prior depression history, cannabis users had 62% higher risk (aRR 1.62, 95% CI 1.02-2.58). Results were adjusted for age, race, insurance, marital status, and smoking.

Why it matters

Some pregnant people use cannabis to manage depression or anxiety symptoms. This study suggests that rather than helping, prenatal cannabis use may increase the risk of postpartum depression.

The numbers in context

799 subjects; 15.9% prenatal cannabis use; PPD risk: aRR 1.60 (95% CI 1.05-2.45); with depression history: aRR 1.62 (95% CI 1.02-2.58); adjusted for age, race, insurance, marital status, smoking

How the study worked

Retrospective cohort study of 799 patients receiving prenatal care at a single institution (2017-2019). Cannabis use was extracted from medical records. Edinburgh Postnatal Depression Scale (EPDS) scores were used to identify PPD. Modified Poisson regression estimated relative risks.

What this study cannot tell us

Retrospective design; single institution; cannot determine if cannabis caused PPD or if shared risk factors drive both; low-income population may not generalize; cannabis use ascertained from medical records which may underreport; no data on cannabis type, dose, or timing

How to read the evidence

Retrospective single-institution cohort with appropriate statistical adjustment and validated PPD screening, but unable to establish causation.

When this study was published

2024 publication analyzing 2017-2019 data

The bigger picture

Postpartum depression affects both maternal wellbeing and infant development. Identifying prenatal cannabis use as an additional risk factor could improve PPD screening and early intervention.

Questions still open

Does the timing or amount of prenatal cannabis use modify PPD risk? Would women who quit cannabis during pregnancy have different PPD rates? Is this association mediated through biological or psychosocial pathways?

Common questions

Does cannabis use during pregnancy increase postpartum depression risk?

This study found a 60% higher risk of screening positive for postpartum depression among prenatal cannabis users, after adjusting for other risk factors. The risk was slightly higher (62%) for women who already had a history of depression.

Should women with depression avoid cannabis during pregnancy?

The findings suggest yes. Women with a depression history who used cannabis during pregnancy had the highest risk of postpartum depression. The authors recommend these results should discourage self-medication with cannabis during pregnancy, particularly for those with existing depression.

Read the original research

Incidence of postpartum depression in low-income cannabis users with and without a history of depression.

Archives of women's mental health, 27(1), 145-151

View on PubMed ↗Publisher’s paper ↗

Citation

Lendel, Anastasia; Richards, Ria; Benedict, Jason; Lynch, Courtney; Schaffir, Jonathan. (2024). Incidence of postpartum depression in low-income cannabis users with and without a history of depression.. Archives of women's mental health, 27(1), 145-151. https://doi.org/10.1007/s00737-023-01389-y