Satti Mohamed A, Reed Eda G, Wenker Elizabeth S, Mitchell Stephanie L, Schulkin Jay, Power Michael L, Mackeen A Dhanya
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Geisinger, Danville, USA.
Center for Species Survival, Smithsonian National Zoological Park and Conservation Biology Institute, 3001 Connecticut Ave NW, Washington DC, 20008, USA.
J Cannabis Res. 2022 Apr 6;4(1):16. doi: 10.1186/s42238-022-00128-x.
Cannabis use among pregnant women has increased. We surveyed pregnant women in rural Pennsylvania to examine cannabis use and opinions regarding its safety during pregnancy. We examined associations between challenges of pregnancy (e.g., exhaustion, pain, nausea) and cannabis use.
A cross-sectional survey was administered to a convenience sample of English-speaking pregnant women receiving prenatal care at Geisinger, May-June 2019. Principal component analysis (PCA) was used to construct three scores (overwhelmed/exhausted, happy/optimistic, and health worries) based on 10 questions regarding common experiences during pregnancy (e.g., nausea/vomiting, pain, exhaustion, mood). A score based on four questions regarding cannabis safety during pregnancy was also constructed.
From a maximum of 300 surveys distributed, 284 were completed (95%). Most participants were white (87%), married (49%) or living with a partner (38%), and had private health insurance (62%). Most women indicated it was unsafe to use alcohol and tobacco products during pregnancy (> 90%), but that proportion dropped to 82% and 63% regarding recreational cannabis and medical cannabis, respectively. Only women with prior cannabis use (23% of sample) continued to do so during pregnancy: 57% of women reporting daily cannabis use prior to pregnancy continued to use cannabis during pregnancy with 33% reporting daily use. Two thirds of users during pregnancy indicated they were self-medicating for: nausea (90%), anxiety (70%), insomnia (30%), and pain management (30%). Many (56%) of the women who used cannabis during pregnancy believed it is safe. Younger women and women who were overwhelmed/exhausted or less happy/optimistic were more likely to believe cannabis use is safe. Women valued healthcare provider advice more than advice from family and friends. Study strengths include a high response rate. Weaknesses include self-report and that is was a convenience sample; however, the demographics of the sample were similar to past studies.
Women with a history of cannabis use, especially daily use, are at risk of continuing during pregnancy and should receive counseling. Younger women and women with greater stressors during pregnancy also are at greater risk. Screening for prior use and for stressors may identify patients that would benefit from enhanced counseling.
孕妇中使用大麻的情况有所增加。我们对宾夕法尼亚州农村地区的孕妇进行了调查，以研究大麻使用情况及其在孕期安全性的相关观点。我们还研究了孕期挑战（如疲惫、疼痛、恶心）与大麻使用之间的关联。
2019年5月至6月，对在盖辛格接受产前护理的讲英语的孕妇便利样本进行了横断面调查。主成分分析（PCA）基于10个关于孕期常见经历（如恶心/呕吐、疼痛、疲惫、情绪）的问题构建了三个分数（不堪重负/疲惫、快乐/乐观、健康担忧）。还基于4个关于孕期大麻安全性的问题构建了一个分数。
在最多分发的300份调查问卷中，完成了284份（95%）。大多数参与者是白人（87%），已婚（49%）或与伴侣同住（38%），并拥有私人医疗保险（62%）。大多数女性表示孕期使用酒精和烟草制品不安全（>90%），但对于娱乐性大麻和医用大麻，这一比例分别降至82%和63%。只有有大麻使用史的女性（占样本的23%）在孕期继续使用：57%在怀孕前报告每日使用大麻的女性在孕期继续使用，其中33%报告每日使用。孕期使用大麻的女性中有三分之二表示她们是为了缓解以下症状而自我用药：恶心（90%）、焦虑（70%）、失眠（30%）和疼痛管理（30%）。许多在孕期使用大麻的女性（56%）认为其是安全的。年轻女性以及那些不堪重负/疲惫或不那么快乐/乐观的女性更有可能认为使用大麻是安全的。女性更看重医疗保健提供者的建议，而非家人和朋友的建议。研究的优势包括高回应率。劣势包括自我报告以及这是一个便利样本；然而，样本的人口统计学特征与过去的研究相似。
有大麻使用史的女性，尤其是每日使用者，在孕期有继续使用的风险，应接受咨询。年轻女性以及孕期压力较大的女性风险也更高。筛查既往使用情况和压力源可能会识别出能从强化咨询中受益的患者。
