Association of Comorbid Behavioral and Medical Conditions with Cannabis Use Disorder in Pregnancy
Table of Contents
Table of Contents
Report Publish Date: November 3, 2021
This journal article examines cannabis use and cannabis use disorder among pregnant people.
Primary Takeaways
The share of prenatal hospitalizations that involved cannabis use disorder, though small, increased between 2010 and 2018. Pregnant people with cannabis use disorder had much higher rates of depression, anxiety, and nausea than pregnant people with no substance use disorders during their hospital stays.
Overview and Objectives
More pregnant people are using cannabis than in the past, yet there are few studies about who uses cannabis and the effects its use has on pregnancy and birth. The authors wanted to know how commonly pregnant people are hospitalized with cannabis use disorder and other mental health and substance use issues.
Hypothesis or Approach
The authors used hospital discharge data from the Healthcare Cost and Utilization Project (HCUP), a network of databases sponsored by the federal Agency for Healthcare Research and Quality. They also used data from states that do not participate in HCUP. They looked at inpatient data from 2010 to 2018, in 35 states.
How This Influences Change
The authors say their study shows a need for screening, prevention, and treatment of pregnant people and for more research on what causes cannabis use disorder during pregnancy and what effects it has on maternal and infant health.
Research: Go Deeper
Importance: Prenatal cannabis use continues to increase, yet studies of the demographic, psychiatric, and medical characteristics associated with cannabis use in pregnancy are limited by size and use of self-report and often do not consider cannabis use disorder (CUD) or concurrent substance use disorders (SUDs). Understanding the factors associated with CUD in pregnancy is paramount for designing targeted interventions.
Objective: To examine the prevalence of co-occurring psychiatric and medical conditions of US pregnant individuals hospitalized with and without CUD by concomitant SUDs.
Design, Setting, and Participants: The study analyzed restricted hospital discharge data from the 2010 to 2018 Healthcare Cost and Utilization Project State Inpatient Databases in 35 states. Data were analyzed from January to August 2021. Weighted linear regressions tested whether the prevalence of psychiatric and medical conditions differed between individuals with and without a CUD diagnosis at hospitalization. Inpatient hospitalizations of pregnant patients aged 15 to 44 years with a CUD diagnosis were identified. Pregnant patients aged 15 to 44 years without a CUD diagnosis were identified for comparison. Patients were further stratified based on concomitant SUD patterns: (1) other SUDs, including at least 1 controlled substance; (2) other SUDs, excluding controlled substances; and (3) no other SUDs.
Exposures: CUD in pregnancy.
Main Outcomes and Measures: Prevalence of demographic characteristics, psychiatric disorders (e.g., depression and anxiety), and medical conditions (eg, epilepsy and vomiting).
Results: The sample included 20 914 591 hospitalizations of individuals who were pregnant. The mean (SD) age was 28.24 (5.85) years. Of the total number of hospitalizations, 249 084 (1.19%) involved CUD and 20 665 507 (98.81%) did not. The proportion of prenatal hospitalizations involving CUD increased from 0.008 in 2010 to 0.02 in 2018. Analyses showed significant differences in the prevalence of almost every medical and psychiatric outcome examined between hospitalizations with and without CUD diagnoses, regardless of concurrent SUDs. Elevations were seen in depression (0.089; 95% CI, 0.083-0.095), anxiety (0.072; 95% CI, 0.066-0.076), and nausea (0.036; 95% CI, 0.033-0.040]) among individuals with CUD only at hospitalization compared with individuals with no SUDs at hospitalization.
Conclusions and Relevance: Considerable growth was observed in the prevalence of CUD diagnoses among individuals hospitalized prenatally and in the prevalence of depression, anxiety, nausea, and other conditions in individuals with CUD at hospitalization. This study highlights the need for more screening, prevention, and treatment, particularly in populations with co-occurring CUD and psychiatric disorders. Research on the determinants and outcomes associated with CUD during pregnancy is needed to guide clinicians, policymakers, and patients in making informed decisions
JAMA Psychiatry. 2022. doi:10.1001/jamapsychiatry.2021.3193
Figure 1. Cannabis Use Disorder (CUD) Among Prenatally Hospitalized Individuals, 2010-2018
Research Team
This study and report was conducted and created by the following people:
- Meinhofer A
- Hinde JM
- Keyes KM
- Lugo-Candelas C
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