Prenatal cannabis use disorder tied to ~40% higher risk of postpartum psychiatric ED visits in California
In a cohort of 2,036,016 California deliveries, women with cannabis use disorder had more postpartum psychiatric ED visits. The authors stress the design shows association, not causation.
Researchers at the University of California, Merced, with colleagues from Michigan State University and UCLA, analysed 2,036,016 deliveries of live infants in California between 2016 and 2021. They compared postpartum psychiatric emergency department (ED) visits by prenatal diagnosis. The results were published in Annals of Epidemiology. Among women diagnosed with cannabis use disorder (CUD) during pregnancy, 10.4% had a postpartum psychiatric ED visit sciencedirect.com
Annals of Epidemiologysciencedirect.comOpen source ↗. The figures were 15.6% for women with alcohol use disorder (AUD) and 2.7% for women with neither diagnosis.
Study design and trends
The team built annual cohorts of women with a live infant delivery from statewide linked hospital and ED discharge data. AUD was included as a benchmark exposure. According to the authors, no prospective studies had previously examined prenatal CUD and psychiatric outcomes in perinatal populations, although cannabis is the most-used substance during pregnancy and is associated with psychosis and depression in general.
Over the study period, the prevalence of prenatal CUD rose from 1.0% to 1.4%. The university release says AUD incidence stayed flat over the same six years. The period began as California voters approved recreational cannabis use. The work is part of a broader National Institutes of Health grant on substance use, violence victimization and self-harm among pregnant and postpartum women.
Risk estimates and limits
Relative to women with neither diagnosis, those with CUD had about 40% higher risk of any postpartum psychiatric ED visit (adjusted RR 1.39, 95% CI 1.32–1.47) sciencedirect.com
Annals of Epidemiologysciencedirect.comOpen source ↗. For AUD, the adjusted risk was 80% higher (RR 1.80, 95% CI 1.56–2.09). The authors conclude that the elevated risk underscores the need for consistent screening, diagnosis and treatment among perinatal women diagnosed with CUD.
Study lead Sidra Goldman-Mellor said the work was not designed to show that CUD causes psychiatric emergencies. In her words, it shows that pregnant women with cannabis addiction are a high-risk group. Co-author LaMecia De Alba noted that the potency and frequency of cannabis products used in specific populations, especially among pregnant and postpartum women, remain poorly understood.
