Use of cannabis to regulate negative affect in pregnancy: Bidirectional findings from an ecological momentary...

Prenatal cannabis use is increasing in the United States, despite evidence of potential harms to pregnant individuals and their offspring. Elevated rates of anxiety and depression among those who use cannabis during pregnancy suggest that mental health difficulties may contribute to prenatal cannabis use. In line with the affect regulation hypothesis, many pregnant individuals endorse using cannabis to manage mood. However, no studies have examined this relationship in real time. Moreover, the acute effects of cannabis on mood during pregnancy remain understudied, limiting knowledge of whether negative affect (NA) relief reinforces continued use. Addressing these gaps, the present study examines the relationship between momentary NA and cannabis use in pregnant adults and explores the effect of cannabis on NA.

Participants (N = 20, M_age = 30.15, M_{gestationalage} = 22.5 weeks, 60% White) completed a baseline session followed by a 14-day ecological momentary assessment burst (average of 14.95 cannabis use events per burst).

Generalized linear mixed-effects models tested whether momentary ratings of depression, anxiety, and irritability predicted subsequent cannabis use (Aim 1), and linear mixed-effects models tested whether cannabis use predicted subsequent changes in NA (Aim 2). Aim 1 results indicated that greater levels of NA (momentary depression, anxiety, and irritability) were associated with greater odds of using cannabis. Aim 2 results suggest cannabis use was followed by reductions in depression, anxiety, and irritability, reflecting short-term NA relief.

Findings provide the first real-time evidence supporting the affect regulation hypothesis in pregnancy and highlight the potential reinforcing role of NA relief in sustaining prenatal cannabis use. (PsycInfo Database Record (c) 2026 APA, all rights reserved).