Cannabis use and stressful life events during the perinatal period: cross‐sectional results from Pregnancy Risk Assessment Monitoring System (PRAMS) data, 2016

Abstract

Aims We aimed to determine the association between stressful life events (SLEs) in the year prior to childbirth with (1) pre‐pregnancy cannabis use, (2) cessation of cannabis use during pregnancy and (3) postpartum relapse to cannabis use. Design We used data from the Pregnancy Risk Assessment Monitoring System (PRAMS) 2016, a cross‐sectional, population‐based surveillance system. Setting Mailed and telephone surveys conducted in five states—Alaska, Colorado, Maine, Michigan and Washington—in the United States. Participants Women (n = 6061) who delivered a live infant within the last 6 months and had data on cannabis use. Measurements Self‐reported data included SLEs (yes/no response for 14 individual events in the 12 months prior to childbirth) and cannabis use [yes/no prior to pregnancy, during pregnancy, and at the time of the survey (approximately 2–6 months postpartum)]. The associations between SLEs and cannabis use (primary outcomes) were examined in logistic regression models adjusted for maternal demographics (e.g. age, race, education), geography (i.e. state of residence) and cigarette smoking. Findings Pre‐pregnancy, 16.4% (997/6061) of respondents endorsed using cannabis, with 36.4% (363/997) continuing cannabis use during pregnancy. Among the 63.6% (634/997) who did not report use during pregnancy, 23.2% (147/634) relapsed to cannabis use during the postpartum. Nine of the 14 possible SLEs were associated with increased odds of pre‐pregnancy cannabis use [e.g. husband/partner or mother went to jail, adjusted odds ratio (aOR) = 2.16, 95% confidence interval (CI) = 1.30–3.62] and four were associated with increased odds of continued cannabis use during pregnancy (e.g. husband/partner lost job, aOR = 2.19, 95% CI = 1.21–3.96). The odds of postpartum relapse to cannabis were significantly associated with two SLEs (husband/partner said they did not want pregnancy, aOR = 2.86, CI = 1.10–7.72; husband/partner or mother went to jail, aOR = 0.37, 95% CI = 0.13–1.00). Conclusions Stressful life events during the year prior to childbirth appear to be linked to greater odds of women's cannabis use during the perinatal period, especially during pre‐pregnancy.

The COVID-19 cannabis health study: Results from an epidemiologic assessment of adults who use cannabis for medicinal reasons in the United States

“…Several studies that investigate the role of major life events (e.g., natural disasters, 11 community violence, 12 trauma or abuse 13 ) and stress, 14 have identified that individuals are likely to increase their substance use (including use of cannabis), in the period immediately following the disaster or traumatic event. [15][16][17][18] When analyzing cannabis use and stressful life events in pregnant women, Allen et al (2020) found that women who experienced stressful life events the year prior to giving birth were more likely to use cannabis during the perinatal period. 19 The purpose of the COVID-19 Cannabis Health Study is to provide data from an electronic self-report questionnaire to assess patterns and trends of possible SARS-CoV-2 exposure, behaviors that may be related to its transmission, and the prevalence of COVID-19 given testing among a group of adult MCUs.…”

“…[15][16][17][18] When analyzing cannabis use and stressful life events in pregnant women, Allen et al (2020) found that women who experienced stressful life events the year prior to giving birth were more likely to use cannabis during the perinatal period. 19 The purpose of the COVID-19 Cannabis Health Study is to provide data from an electronic self-report questionnaire to assess patterns and trends of possible SARS-CoV-2 exposure, behaviors that may be related to its transmission, and the prevalence of COVID-19 given testing among a group of adult MCUs. The objectives of this study were (1) to provide data on selfreported behavioral changes among adult MCUs since COVID-19 was declared a pandemic, characterized by preexisting chronic health conditions; and (2) to provide prevalence estimates of COVID-19 symptoms, testing, and infections among adult MCUs.…”

Commentary on Allen et al. (2020): Cannabis use during pregnancy—the importance of a life‐course health disparities framework

“…Research by Allen et al [1]-published in this issue-provides several important contributions, but none stands out more clearly than the finding that approximately one in three women reporting cannabis use prior to becoming pregnant continue to use cannabis during pregnancy. This is a disconcerting discovery, particularly in light of evidence that prenatal cannabis exposure is related to key neonatal [2] and, potentially, longer-term deleterious developmental outcomes [3].…”

“…

As we consider the evidence related to continued cannabis use during pregnancy—and develop programs to target this issue—it is vital we consider how distal and proximal stressors, including those related to social disadvantage, influence perinatal cannabis use risk over time .

Research by Allen et al . [1]—published in this issue—provides several important contributions, but none stands out more clearly than the finding that approximately one in three women reporting cannabis use prior to becoming pregnant continue to use cannabis during pregnancy. This is a disconcerting discovery, particularly in light of evidence that prenatal cannabis exposure is related to key neonatal [2] and, potentially, longer‐term deleterious developmental outcomes [3].…”

“…Indeed, close inspection of the findings by Allen et al . [1] suggests that a health disparities lens would further strengthen the study's contribution.…”