Faculty of Medicine, School of Public Health, Centre for Longitudinal and Life Course Research, The University of Queensland, Brisbane, Queensland, Australia.
Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia.
Drug Alcohol Depend. 2021 Sep 1;226:108860. doi: 10.1016/j.drugalcdep.2021.108860. Epub 2021 Jun 25.
Evidence suggests a positive association between cannabis use and depression however whether preconception cannabis use is associated with postpartum depression (PPD) remains unknown. This study examined the association using a longitudinal design.
Participants were from the Australian Longitudinal Study on Women's Health (cohort born in 1989-95), a sample broadly representative of similarly aged Australian women. The association of past year cannabis use at 3-15 months prior to pregnancy with PPD at ages 19-24 to 22-27 was examined in 516 women with 570 singleton live births. The associations of chronicity, recency, and initiation of cannabis use before pregnancy with PPD at ages 21-26 to 24-29 were investigated in 538 women with 590 singleton live births. PPD was ascertained from self-report of doctor diagnosis for each birth. Relative risk (RR) and 95 % confidence interval (CI) were used to calculate the associations of interest.
Compared with no cannabis use, any past-year cannabis use at 3-15 months before pregnancy may be associated with an increased risk of PPD (1.50, 0.99-2.28). Compared with no cannabis use in the first three annual surveys before pregnancy, chronic use (a past year user in ≥ 2 surveys) was associated with an 80 % higher risk of incident PPD for births in the following 1-4 years (1.80, 1.22-2.68). Compared to never users at ages 20-25, former users who had no use within the past year had no increased risk; past year users had 73 % higher risk (1.73, 1.07-2.81); and past year users who initiated cannabis use at or after age 18 had twice the risk of incident PPD for births in the following 1-4 years (2.02, 1.17-3.49).
This study provides evidence that preconception cannabis use is associated with increased risk of PPD. More studies are warranted to confirm this finding before cannabis cessation policies can be reinforced on reducing the risk of PPD.
有证据表明大麻使用与抑郁之间存在正相关关系，但孕前大麻使用是否与产后抑郁症（PPD）相关仍不清楚。本研究使用纵向设计来检验这种关联。
参与者来自澳大利亚女性健康纵向研究（1989-1995 年出生的队列），这是一个年龄与澳大利亚同龄女性相似的样本。在 516 名有 570 名单胎活产的女性中，检查了孕前 3-15 个月过去一年的大麻使用与 19-24 岁至 22-27 岁时 PPD 的关联。在 538 名有 590 名单胎活产的女性中，调查了孕前大麻使用的慢性、近期和起始与 21-26 岁至 24-29 岁时 PPD 的关联。通过每次分娩的医生诊断自我报告来确定 PPD。使用相对风险（RR）和 95%置信区间（CI）来计算相关关联。
与无大麻使用相比，孕前 3-15 个月的任何过去一年的大麻使用可能与 PPD 风险增加相关（1.50，0.99-2.28）。与孕前前三年的年度调查中没有大麻使用相比，慢性使用（过去一年中≥2 次调查的使用者）与随后 1-4 年内发生 PPD 的风险增加 80%相关（1.80，1.22-2.68）。与 20-25 岁时从未使用者相比，过去一年无使用者无风险增加；过去一年使用者的风险增加 73%（1.73，1.07-2.81）；过去一年使用者在 18 岁或以后开始使用大麻，随后 1-4 年内发生 PPD 的风险增加一倍（2.02，1.17-3.49）。
本研究提供了孕前大麻使用与 PPD 风险增加相关的证据。在可以加强大麻戒断政策以降低 PPD 风险之前，需要进行更多的研究来证实这一发现。
