The Ohio State University College of Medicine, Columbus, OH, USA.
Department of Obstetrics and Gynecology, MedStar Health-Washington Hospital Center, Washington, DC, USA.
Arch Womens Ment Health. 2024 Feb;27(1):145-151. doi: 10.1007/s00737-023-01389-y. Epub 2023 Nov 1.
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.
虽然过去的研究已经将怀孕期间使用大麻与抑郁史联系起来，但关于怀孕期间使用大麻与产后抑郁症（PPD）的文献很少。在这项研究中，我们旨在更好地了解有和没有抑郁史的人群中 PPD 与怀孕期间使用大麻之间的关联。这是一项回顾性队列研究，研究对象为 2017 年 1 月至 2019 年 12 月在一家机构接受产前护理的患者。从患者的病历中提取患者的人口统计学、产科史、抑郁史、物质使用史和爱丁堡产后抑郁量表（EPDS）评分。使用具有稳健标准误差的修正泊松回归来估计筛查出 PPD 的相对风险（RR），调整分娩时的年龄、种族/民族、保险类型、婚姻状况和吸烟史。在符合纳入标准的 799 名受试者中，15.9%在怀孕期间使用大麻。与非使用者相比，产前大麻使用者筛查出 PPD 的风险增加（aRR = 1.60，95%CI：（1.05，2.45））。在有抑郁史的个体中，与非使用者相比，产后就诊时筛查出 PPD 症状的调整后相对风险在大麻使用者中增加了 1.62 倍（95%CI：（1.02，2.58））。产前大麻使用与筛查出 PPD 呈正相关，尤其是在有抑郁史的个体中。这些结果应劝阻有抑郁史的女性在怀孕期间自我用大麻治疗，并为现有的禁止产前使用大麻的建议提供额外支持。
