Cannabis use disorder during pregnancy on the rise

Topic: Cannabis use disorder during pregnancy on the rise

As more states legalize cannabis for medical or recreational purposes, its use during pregnancy is increasing – along with the potential for abuse or dependence.

A new study, co-led by researchers from Weill Cornell Medicine and Columbia University, has captured the magnitude and issues related to cannabis use disorders during pregnancy by examining diagnostic codes for more than 20 million U.S. hospital discharges. Most of those hospitalizations were for childbirth.

The study, “Association of Comorbid Behavioral and Medical Conditions with Cannabis Use Disorder in Pregnancy,” published Nov. 3 in JAMA Psychiatry, found that the proportion of hospitalized pregnant patients identified with cannabis use disorder – defined as cannabis use with clinically significant impairment or distress – rose 150% from 2010 to 2018.

“This is the largest study to document the scale of cannabis use disorder in prenatal hospitalizations,” said Claudia Lugo-Candelas, assistant professor of clinical medical psychology in Columbia’s Department of Psychiatry and one of the study’s co-authors.

Lugo-Candelas said the study found that pregnant patients with the condition had sharply higher levels of depression, anxiety and nausea – results warranting clinical concern. “It’s a red flag that patients may not be getting the treatment they need,” she said.

Cannabis is legal for medical and recreational use in 37 states, and legalization has likely lessened fears about its risks in pregnancy. Some pregnant patients use cannabis instead of prescribed medications, thinking it’s a safer choice. Both the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists have recommended against using cannabis while pregnant, chiefly because of known and unknown fetal effects. Concerns for maternal effects focus on smoking or vaping risks, not mental health.

The study identified 249,084 hospitalized pregnant patients with cannabis use disorder and classified them into three sub-groups:

• those with cannabis use disorder only;
• those with use disorders for cannabis and other substances, including at least one controlled substance; and
• those with cannabis use disorder and other substances (alcohol, tobacco) not related to controlled substances.

Data from hospitalized pregnant patients without any substance use disorders were analyzed for comparison.

Those with the cannabis condition were more likely to be younger (ages 15 to 24); Black non-Hispanic; and covered by Medicaid rather than private insurance.

Topic Discussed: Cannabis use disorder during pregnancy on the rise

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