Pregnant Women With Cannabis Use Disorder Likely to Have Other Comorbid Psychiatric Conditions

Pregnant women who had a diagnosis of cannabis use disorder (CUD) were more likely to have other psychiatric disorders and medical conditions. These findings were published in JAMA Psychiatry.

Data were sourced from the Healthcare Cost and Utilization Project which is the largest collection of hospital data in the United States. Pregnant women who were hospitalized between 2010 and 2018 were assessed for incidence of CUD, concomitant substance use disorders (SUDs), psychiatric disorders, and medical conditions.

Women were aged mean 28.24 (range, 15-44) years, 58.05% were White, 18.41% Black, and 14.31% Hispanic.

The proportion of women hospitalized who had CUD was 0.008 in 2010 and 0.02 in 2018. The incidence rate of CUD alone, CUD with SUD of noncontrolled substances, and CUD with SUD of controlled substances were increasing over time.

Compared with women who did not have CUD, CUD associated with higher rates of cocaine, amphetamine, tobacco, and alcohol use disorders and lower rates of opioid use disorders.

Women with CUD and no SUD were associated with higher rates of mood disorders (57.94% vs 4.81%), depression (10.31% vs 2.69%), anxiety (8.66% vs 2.57%), trauma (2.47% vs 0.29%), attention-deficit/hyperactivity disorder (1.44% vs 0.25%), epilepsy (1.38% vs 0.44%), chronic pain (2.64% vs 1.13%), vomiting (4.86% vs 1.02%), nausea (0.82% vs 0.25%), HIV/AIDS (0.45% vs 0.13%), and hepatitis C (0.67% vs 0.14%) compared with women without CUD or SUD, respectively.

A weighted linear regression found that every medical and psychiatric outcome, except multiple sclerosis, differed significantly on the basis of CUD even when stratifying by SUDs with and without controlled substances. Compared with women without either CUD or SUD, CUD associated with a 360% increased prevalence in vomiting, 329.6% increase in depression, and 277% increase in anxiety.

As most hospitalizations occurred for childbirth, these findings may not be generalizable for women early in their pregnancy.

This study found that the instance of CUD has been increasing over the last decade among pregnant women and that women who have CUD during pregnancy are likely to have comorbid psychological or medical conditions.

“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,” the researchers wrote.

“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, policy makers, and patients in making informed decisions.”

Reference

Meinhofer A, Hinde JM, Keyes KM, Lugo-Candelas C. Association of comorbid behavioral and medical conditions with cannabis use disorder in pregnancy. JAMA Psychiatry. Published on November 3, 2021. doi:10.1001/jamapsychiatry.2021.3193