Prenatal hospitalizations involving cannabis use disorder increased in recent years

Researchers reported an increase in prenatal hospitalizations involving cannabis use disorder between 2010 and 2018, according to study results published in JAMA Psychiatry.

“A recent study documented increased prevalence of anxiety, depression and trauma in 11,681 patients who used cannabis prenatally,” Angélica Meinhofer, PhD, of the department of population health sciences at Weill Cornell Medicine in New York, and colleagues wrote. “However, most studies have been limited by relying on self-reported cannabis use and mood-related disorders, by examining cannabis use and not [cannabis use disorder (CUD)] or by not considering concomitant [substance use disorders (SUDs)]. As the prevalence of polysubstance use among pregnant people who use cannabis is substantial, it is critical to consider whether it may obfuscate factors specifically associated with CUD.”

The researchers aimed to investigate the prevalence of co-occurring psychiatric and medical conditions among 20,914,591 U.S. pregnant individuals (mean age, 28.24 years) hospitalized with and without CUD by concomitant SUDs. They obtained restricted hospital discharge data from the 2010 to 2018 Healthcare Cost and Utilization Project State Inpatient Databases in 35 states. Using weighted linear regressions, they examined potential differences in the prevalence of psychiatric and medical conditions between those with and without a CUD diagnosis at hospitalization. Further, they pinpointed inpatient hospitalizations of pregnant patients aged 15 to 44 years diagnosed with CUD. The researchers further stratified patients according to concomitant SUD patterns; other SUDs, including one or more controlled substances; other SUDs, excluding controlled substances; and no other SUDs. Main outcomes and measures included prevalence of demographic characteristics, psychiatric disorders and medical conditions.

Results showed 249,084 (1.19%) hospitalizations involving CUD and 20,665,507 (98.91%) not involving it. Meinhofer and colleagues noted an increase in the proportion of prenatal hospitalizations that involved CUD from 0.008 in 2010 to 0.02 in 2018. Analyses revealed significant differences in the prevalence of nearly all medical and psychiatric outcome evaluated between hospitalizations with and without diagnoses of CUD, regardless of concomitant SUDs. The researchers observed increases in depression (0.089; 95% CI, 0.083-0.095), anxiety (0.072; 95% CI, 0.066-0.076) and nausea (0.036; 95% CI, 0.033-0.04) among those with CUD only at hospitalization vs. those with no SUDs at hospitalization.

“Our study highlights the need for more treatment and support and research that empowers pregnant patients to make the best decisions for themselves and their offspring,” Meinhofer and colleagues wrote.