Continued cannabis use during pregnancy associated with higher anxiety and depression scores
Among 604 pregnant women, those who continued using cannabis throughout pregnancy were significantly more likely to have elevated anxiety and depression scores compared to non-users, with depression predicting continued use over quitting.
Quick Facts
What This Study Found
Women who continued cannabis use had significantly higher odds of elevated GAD scores (2.55, 95% CI 1.31-4.99) and EPDS depression scores (2.75, 95% CI 1.43-5.28) compared to non-users. Women with higher depression scores had 2.70 times the odds of continuing use rather than quitting.
Key Numbers
604 women; 221 (36.3%) positive for cannabis at care initiation; continued use: GAD OR 2.55, EPDS OR 2.75 vs non-users; higher depression scores: 2.70x odds of continuing vs quitting
How They Did This
Retrospective cohort at a single site evaluated urine toxicology for cannabis at two time points to categorize 604 women as never-used, quit, or continued. Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder scores were compared using multinomial logistic regression.
Why This Research Matters
Cannabis use during pregnancy is common (36.3% tested positive at care initiation in this sample), and mental health symptoms may drive continued use. Understanding this bidirectional relationship is important for designing interventions that address both issues simultaneously.
The Bigger Picture
The finding that depression predicted continued cannabis use during pregnancy suggests some women may be self-medicating. Simply advising cessation without addressing underlying mental health needs may be ineffective.
What This Study Doesn't Tell Us
Single site, retrospective design. Urine testing has a limited detection window. Cannot determine whether cannabis use caused mood symptoms or vice versa. No data on cannabis use patterns, amounts, or products.
Questions This Raises
- ?Would treating depression and anxiety reduce cannabis use during pregnancy?
- ?Are women using cannabis to manage mood symptoms, and if so, what alternatives could be offered?
- ?Do these associations persist postpartum?
Trust & Context
- Key Stat:
- 2.75x higher odds of elevated depression scores in continued cannabis users
- Evidence Grade:
- Moderate sample size with objective toxicology confirmation and validated screening tools, but single-site retrospective design limits causal inference.
- Study Age:
- Published in 2021.
- Original Title:
- Association between continued cannabis use during pregnancy and symptoms of anxiety and depression.
- Published In:
- International review of psychiatry (Abingdon, England), 33(6), 528-533 (2021)
- Authors:
- Mark, Katrina(3), Otieno, Linda, Moore, Ellen, Zehra, Amna, Mitchell, Mary
- Database ID:
- RTHC-03321
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Did quitting cannabis during pregnancy help with mood symptoms?
The study did not find significant differences in anxiety or depression score changes between groups over time, but women who continued using had higher baseline scores than those who quit.
How common was cannabis use in this study?
Over a third (36.3%) of the 604 women tested positive for cannabis at the start of prenatal care.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-03321APA
Mark, Katrina; Otieno, Linda; Moore, Ellen; Zehra, Amna; Mitchell, Mary. (2021). Association between continued cannabis use during pregnancy and symptoms of anxiety and depression.. International review of psychiatry (Abingdon, England), 33(6), 528-533. https://doi.org/10.1080/09540261.2021.1898348
MLA
Mark, Katrina, et al. "Association between continued cannabis use during pregnancy and symptoms of anxiety and depression.." International review of psychiatry (Abingdon, 2021. https://doi.org/10.1080/09540261.2021.1898348
RethinkTHC
RethinkTHC Research Database. "Association between continued cannabis use during pregnancy ..." RTHC-03321. Retrieved from https://rethinkthc.com/research/mark-2021-association-between-continued-cannabis
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.