Self-Reported Cannabis Use in Pregnancy and Maternal Psychological Health

Cannabis use is increasing in the United States, including among pregnant women. Legalization of cannabis and decreased public perceptions of risk have contributed to increased cannabis use. Relatively few studies have examined the association of cannabis use with maternal mental health in pregnancy, particularly among Black women who have higher rates of adverse pregnancy outcomes.

Biosocial Impacts on Black Births (BIBB) is a prospective study conducted from 2017-2022 in three prenatal care sites in Michigan, Ohio and Florida with pregnant Black women (n = 1,066). We examined the associations between self-reported cannabis use in pregnancy and psychological health. Psychological health was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), the Cohen's Perceived Stress Scale, and the Psychological General Well-Being (PGWB) Index.

Over 20% of women (n = 227) reported cannabis use during pregnancy. The mean age was 27 years, >60% of the participants completed a high school education, and 85% were living with the father of the baby. The most common reasons for use were to reduce stress and nausea. After controlling for confounding by state of residence, maternal age, education level, marital status, current financial status, gestational age at enrollment, and tobacco use, cannabis use in pregnancy was associated with higher levels of depressive symptoms (β = 3.44; 95% CI: 1.8, 5.1), higher perceived stress (β = 2.78; CI: 1.8, 3.7), and lower levels of maternal psychological well-being (β = -4.5; CI: -7.1, -1.9).

These findings highlight the importance of health care provider awareness about prenatal cannabis use and psychological health in pregnant women. Prospective studies are needed to examine factors related to cannabis use in pregnancy to potentially reduce adverse outcomes associated with use.