Emery Rebecca L, Gregory Melissa P, Grace Jennifer L, Levine Michele D
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA; University of Pittsburgh, Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA.
Addict Behav. 2016 Mar;54:52-8. doi: 10.1016/j.addbeh.2015.12.008. Epub 2015 Dec 15.
Following tobacco and alcohol, cannabis is the most commonly used substance during pregnancy. Given the high prevalence of concurrent cannabis and tobacco use as well as the health consequences associated with prenatal substance use, we sought to document the relative contributions of psychosocial and psychiatric factors commonly associated with cannabis use in predicting a lifetime cannabis use disorder (CUD) among women who had quit smoking tobacco as a result of pregnancy.
Pregnant former tobacco smokers (n=273) enrolled in a larger randomized controlled trial for postpartum tobacco relapse prevention completed semi-structured psychiatric interviews and self-reported demographic, pregnancy, health, psychosocial, and tobacco use factors during their third trimester of pregnancy.
In total, 14% (n=38) of women met criteria for a lifetime CUD. The strongest predictors of a lifetime CUD were a history of having multiple psychiatric disorders (OR=36.44; 95% CI=5.03-264.27; p<0.001) followed by a lifetime alcohol use disorder (OR=3.54; 95% CI=1.27-9.87; p<0.05). In addition, more frequent attempts to quit smoking tobacco (OR=1.12; 95% CI=1.01-1.25; p<0.05) and lower self-efficacy about weight management after quitting smoking tobacco (OR=0.78; 95% CI=0.62-0.97; p<0.05) also were significantly associated with a lifetime CUD.
Women with a history of both cannabis and tobacco dependence may represent a subset of women who need more specialized treatment during the perinatal period to improve substance use outcomes.
除烟草和酒精外，大麻是孕期最常用的物质。鉴于大麻和烟草同时使用的高流行率以及产前物质使用相关的健康后果，我们试图记录与大麻使用常见相关的心理社会和精神因素在预测因怀孕而戒烟的女性终生大麻使用障碍（CUD）方面的相对贡献。
参加一项更大规模预防产后烟草复吸随机对照试验的怀孕前吸烟者（n = 273）在孕期第三个月完成了半结构化精神访谈，并自我报告了人口统计学、怀孕、健康、心理社会和烟草使用因素。
总共14%（n = 38）的女性符合终生CUD标准。终生CUD的最强预测因素是有多种精神障碍病史（OR = 36.44；95%CI = 5.03 - 264.27；p < 0.001），其次是终生酒精使用障碍（OR = 3.54；95%CI = 1.27 - 9.87；p < 0.05）。此外，更频繁的戒烟尝试（OR = 1.12；95%CI = 1.01 - 1.25；p < 0.05）以及戒烟后体重管理的自我效能较低（OR = 0.78；95%CI = 0.62 - 0.97；p < 0.05）也与终生CUD显著相关。
有大麻和烟草依赖史的女性可能是围产期需要更专门治疗以改善物质使用结果的女性亚组。
