Pregnant women with depression are more than 3 times more likely to use cannabis

March 3, 2020 - Cannabis use is much more common among pregnant women with depression and pregnant women with depression are more than 3 times more likely to use cannabis than those without depression, according to a new study at Columbia University Mailman School of Public Health. Despite data linking cannabis and depression in many populations, this is the first study to examine this relationship among pregnant women in a nationally representative sample. The findings are online in the journal Drug and Alcohol Dependence.

Data were drawn from the 2005-2018 National Survey on Drug Use and Health (NSDUH), an annual survey of persons ages 12 and older in the US. Pregnant women were categorized as a current cannabis user if they responded they has used marijuana at least once during the past 30 days. The study, conducted with colleagues at The City University of New York, also investigated whether the relationship between depression and cannabis use differed by age, other sociodemographic characteristics, and perception of risk associated with cannabis use.

"Our findings are timely given rapidly shifting perceptions about risks associated with cannabis use and its legalization," said Renee Goodwin, PhD, in the Department of Epidemiology at Columbia Mailman School. "We found the prevalence of cannabis use was much higher among those with depression who perceived no risk (24 percent) relative to those who perceived moderate-great risk associated with use (5.5 percent)."

Among pregnant women without depression, those who perceived no risk had higher levels of use (16.5 percent) compared with those who perceived moderate-great risk (0.9 percent), though both these levels were substantially lower than among women with depression.

Depression appears to increase vulnerability to cannabis use even among pregnant women who perceive substantial risk. "Perception of greater risk associated with regular use seems to be a barrier to cannabis use, though pregnant women with depression who perceived moderate-great risk associated with regular cannabis use were more than 6 times as likely to use cannabis than those without depression. This suggests that depression may lead to use even among those who perceive high risk," noted Goodwin. "With legalization, the degree to which dangers are thought to be linked with cannabis use appear to be declining in the U.S. overall, and this may also apply to pregnant women."

Cannabis use was significantly more common among pregnant women with, compared to without, depression. Over one in ten (13 percent) pregnant women with a major depressive episode reported past-month cannabis use compared with 4 percent without depression who reported using cannabis. This was the case across all sociodemographic subgroups.

Approximately one in four pregnant teens with depression used cannabis in the past month. "As brain development is ongoing until age 25, cannabis use in this group may increase risks for both mother and offspring," she noted." "Our results provide recent nationally representative estimates suggesting that education and intervention efforts should be targeted at pregnant teens."

"Education about risks associated with cannabis use during pregnancy for both mother and offspring, especially among women with prenatal depression, are needed as cannabis is rapidly being legalized across the U.S. and increases among pregnant women have previously been reported," suggested Goodwin.

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Co- authors are Jiaqi Zhu, Zoe Heisler, Katarzyna Wyka, The City University of New York, Melody Wu of Columbia Mailman School; Torri Metz, University of Utah Health; and Rina Das Eiden, Pennsylvania State University.

This work was supported by the National Institutes of Health/ National Institute on Drug Abuse [grant number #DA20892].

Columbia University Mailman School of Public Health

Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the seventh largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master's and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit http://www.mailman.columbia.edu.