Exploring the relationship between avoidance coping and cannabis use among black pregnant women

This study examined the association between avoidance coping and prenatal cannabis use among Black pregnant women and explored whether perceived stress mediated this relationship.

Data were drawn from the Biosocial Impact on Black Births (BIBB) study, a prospective cohort that enrolled Black pregnant women (18-45 years) with singleton pregnancies from prenatal clinics in Detroit (MI), Columbus (OH), and Orlando (FL) between 2017-2022. Participants completed a validated measure of the Revised Prenatal Coping Inventory for avoidance coping and self-reported ever use of cannabis during pregnancy. Logistic regression was used to adjust for maternal age, household income, education level, marital status, social support, gestational age at enrollment, and state of residence. Mediation analysis assessed perceived stress as a potential mediator using regression-based path models and the Sobel test.

Among 1,066 participants with cannabis use data, 21.3 % reported using cannabis during pregnancy. After adjustment, avoidance coping strategy was significantly associated with prenatal cannabis use, suggesting that individuals who rely more on avoidance coping are more likely to use cannabis during pregnancy. Compared to the lowest tertile, the odds of prenatal cannabis use were 1.80 (95 % CI: 1.19-2.76) in the second tertile and 2.45 (95 % CI: 1.61-3.76) in the third tertile of avoidance coping. Mediation analysis showed that perceived stress mediated this relationship (p < 0.05), accounting for 36.4 % of the total effect.

Findings underscore the importance of promoting adaptive coping strategies and addressing psychological stress in culturally responsive health interventions to reduce reliance on prenatal cannabis use.