Top

Published in:

01-11-2023 | Postpartum Depression | Original Article

Incidence of postpartum depression in low-income cannabis users with and without a history of depression

Authors: Anastasia Lendel, Ria Richards, Jason Benedict, Courtney Lynch, Jonathan Schaffir

Published in: Archives of Women's Mental Health | Issue 1/2024

Abstract

While past research has linked cannabis use in pregnancy with a history of depression, sparse literature exists on cannabis use during pregnancy and postpartum depression (PPD). In this study, we aimed to better understand the association between PPD and cannabis use during pregnancy in those with and without a history of depression. This was a retrospective cohort study of patients who received prenatal care at a single institution between January 2017 and December 2019. Patient demographics, obstetric history, depression history, substance use history, and Edinburgh Postnatal Depression Scale (EPDS) scores were extracted from patients’ medical records. Modified Poisson Regression with robust standard errors was used to estimate the relative risk (RR) of screening positive for PPD, adjusting for age at delivery, race/ethnicity, insurance type, marital status, and smoking history. Among the 799 subjects meeting inclusion criteria, 15.9% used cannabis during pregnancy. There was an increased risk of screening positive for PPD among prenatal cannabis users compared to non-users (aRR = 1.60, 95% CI: (1.05, 2.45)). Among individuals with a history of depression, the adjusted relative risk of screening positive for symptoms of PPD at the postpartum visit was 1.62 times greater in cannabis users compared to non-users (95% CI: (1.02, 2.58)). Prenatal cannabis use is associated with screening positive for PPD, particularly in those individuals with a history of depression. These results should discourage women with depression from self-medicating with cannabis in pregnancy and provide additional support to the existing recommendations to abstain from prenatal cannabis use.

Agrawal A, Rogers CE, Lessov-Schlaggar CN, Carter EB, Lenze S, Grucza RA (2019) Changes in alcohol, cigarette and cannabis use between 2002 and 2016 in pregnant females from a nationally representative sample. JAMA Pediatr 173(1):95–96. https://doi.org/10.1001/jamapediatrics.2018.3096CrossRefPubMed

American College of Obstetricians and Gynecologists Committee on Obstetric Practice (2017) Committee opinion no. 722: marijuana use during pregnancy and lactation. Obstet Gynecol 130:e205–e209CrossRef

Barbosa-Leiker C, Burduli E, Smith CL, Brooks O, Orr M, Gartstein M (2020) Daily cannabis use during pregnancy and postpartum in a state with legalized recreational cannabis. J Addict Med 14(6):467–474. https://doi.org/10.1097/ADM.0000000000000625CrossRefPubMedPubMedCentral

Brown QL, Sarvet AL, Shmulewitz D, Martins SS, Wall MM, Hasin DS (2017) Trends in marijuana use among pregnant and nonpregnant reproductive-aged women, 2002-2014. JAMA 317(2):207–209. https://doi.org/10.1001/jama.2016.17383CrossRefPubMedPubMedCentral

Cao S, Jones M, Tooth L, Mishra GD (2021) Association between preconception cannabis use and risk of postpartum depression: findings from an Australian longitudinal cohort. Drug Alcohol Depend 226:108860. https://doi.org/10.1016/j.drugalcdep.2021.108860CrossRefPubMed

Chang JC, Tarr JA, Holland CL et al (2019) Beliefs and attitudes regarding prenatal marijuana use: perspectives of pregnant women who report use. Drug Alcohol Depend 196:14–20. https://doi.org/10.1016/j.drugalcdep.2018.11.028CrossRefPubMedPubMedCentral

Corsi DJ, Hsu H, Weiss D, Fell DB, Walker M (2019) Trends and correlates of cannabis use in pregnancy: a population-based study in Ontario, Canada from 2012 to 2017. Can J Public Health 110(1):76–84. https://doi.org/10.17269/s41997-018-0148-0CrossRefPubMed

Corsi DJ, Donelle J, Sucha E et al (2020) Maternal cannabis use in pregnancy and child neurodevelopmental outcomes. Nat Med 26(10):1536–1540. https://doi.org/10.1038/s41591-020-1002-5CrossRefPubMed

Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786. https://doi.org/10.1192/bjp.150.6.782CrossRefPubMed

Crume TL, Juhl AL, Brooks-Russell A, Hall KE, Wymore E, Borgelt LM (2018) Cannabis use during the perinatal period in a state with legalized recreational and medical marijuana: the association between maternal characteristics, breastfeeding patterns, and neonatal outcomes. J Pediatr 197:90–96. https://doi.org/10.1016/j.jpeds.2018.02.005CrossRefPubMed

Gnofam M, Allshouse AA, Stickrath EH, Metz TD (2020) Impact of marijuana legalization on prevalence of maternal marijuana use and perinatal outcomes. Am J Perinatol 37(1):59–65. https://doi.org/10.1055/s-0039-1696719CrossRefPubMed

Goldschmidt L, Richardson GA, Willford J, Day NL (2008) Prenatal marijuana exposure and intelligence test performance at age 6. J Am Acad Child Adolesc Psychiatry 47(3):254–263. https://doi.org/10.1097/CHI.0b013e318160b3f0CrossRefPubMed

Goodwin RD, Zhu J, Heisler Z et al (2020) Cannabis use during pregnancy in the United States: the role of depression. Drug Alcohol Depend 210:107881. https://doi.org/10.1016/j.drugalcdep.2020.107881CrossRefPubMed

Greenland S, Pearl J, Robins JM (1999) Causal diagrams for epidemiologic research. Epidemiology 10(1):37–48CrossRefPubMed

Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377–381. https://doi.org/10.1016/j.jbi.2008.08.010CrossRefPubMed

Holland CL, Rubio D, Rodriguez KL et al (2016) Obstetric health care providers’ counseling responses to pregnant patient disclosures of marijuana use. Obstet Gynecol 127(4):681–687. https://doi.org/10.1097/AOG.0000000000001343CrossRefPubMedPubMedCentral

Ko JY, Farr SL, Tong VT, Creanga AA, Callaghan WM (2015) Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age. Am J Obstet Gynecol 213(2):201.e1–201.e10. https://doi.org/10.1016/j.ajog.2015.03.021CrossRefPubMed

Ko JY, Tong VT, Bombard JM, Hayes DK, Davy J, Perham-Hester KA (2018) Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: a population-based study. Drug Alcohol Depend 187:72–78. https://doi.org/10.1016/j.drugalcdep.2018.02.01CrossRefPubMedPubMedCentral

Mark K, Gryczynski J, Axenfeld E, Schwartz RP, Terplan M (2017) Pregnant women’s current and intended cannabis use in relation to their views toward legalization and knowledge of potential harm. J Addict Med 11(3):211–216. https://doi.org/10.1097/ADM.0000000000000299CrossRefPubMed

Odom GC, Cottler LB, Striley CW, Lopez-Quintero C (2020) Perceived risk of weekly cannabis use, past 30-day cannabis use, and frequency of cannabis use among pregnant women in the United States. Int J Women's Health 12:1075–1088. https://doi.org/10.2147/IJWH.S266540CrossRef

Pike CK, Sofis MJ, Budney AJ (2021) Correlates of continued cannabis use during pregnancy. Drug Alcohol Depend 227:108939. https://doi.org/10.1016/j.drugalcdep.2021.108939CrossRefPubMedPubMedCentral

R Core Team (2022) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/

Shorey S, Chee CYI, Ng ED, Chan YH, Tam WWS, Chong YS (2018) Prevalence and incidence of postpartum depression among healthy mothers: a systematic review and meta-analysis. J Psychiatr Res 104:235–248. https://doi.org/10.1016/j.jpsychires.2018.08.001CrossRefPubMed

Silverman ME, Reichenberg A, Savitz DA et al (2017) The risk factors for postpartum depression: a population-based study. Depress Anxiety 34(2):178–187. https://doi.org/10.1002/da.22597CrossRefPubMedPubMedCentral

Skelton KR, Hecht AA, Benjamin-Neelon SE (2020) Recreational cannabis legalization in the US and maternal use during the preconception, prenatal, and postpartum periods. Int J Environ Res Public Health 17(3):909. https://doi.org/10.3390/ijerph17030909CrossRefPubMedPubMedCentral

Volkow ND, Han B, Compton WM, McCance-Katz EF (2019) Self-reported medical and nonmedical cannabis use among pregnant women in the United States. JAMA 322(2):167–169. https://doi.org/10.1001/jama.2019.7982CrossRefPubMedPubMedCentral

Young-Wolff KC, Sarovar V, Tucker LY et al (2019) Self-reported daily, weekly, and monthly cannabis use among women before and during pregnancy. JAMA Netw Open 2(7):e196471. https://doi.org/10.1001/jamanetworkopen.2019.6471CrossRefPubMedPubMedCentral

Young-Wolff KC, Sarovar V, Tucker LY et al (2020) Association of depression, anxiety, and trauma with cannabis use during pregnancy. JAMA Netw Open 3(2):e1921333. https://doi.org/10.1001/jamanetworkopen.2019.21333CrossRefPubMedPubMedCentral

Title: Incidence of postpartum depression in low-income cannabis users with and without a history of depression
Authors: Anastasia Lendel
Ria Richards
Jason Benedict
Courtney Lynch
Jonathan Schaffir
Publication date: 01-11-2023
Publisher: Springer Vienna
Keywords: Postpartum Depression
Postpartum Depression
Mood Disorders
Affective Disorder
Published in: Archives of Women's Mental Health / Issue 1/2024
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI: https://doi.org/10.1007/s00737-023-01389-y

At a glance: The STEP trials

Springer Medicine

Incidence of postpartum depression in low-income cannabis users with and without a history of depression

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2024

Consensus pregnancy-related criteria for suicide and unintentional overdoses using a Delphi process

Postmarketing safety profile of brexanolone: a pharmacovigilance analysis based on FDA Adverse Event Reporting System (FAERS)

Job dissatisfaction as a risk factor of depressive symptoms and suicidal ideation among female workers: evidence from a nationwide longitudinal study in South Korea

Personality and gender prototypes for predicting health: a multilevel and cluster analysis

The impact of comorbid premenstrual syndrome or premenstrual dysphoric disorder on the clinical characteristics of bipolar disorder among Han Chinese women

Sex differences in schizophrenia-spectrum diagnoses: results from a 30-year health record registry