Coping with Cannabis During Pregnancy: Trajectories of Depression, Stress, and Cannabis Use across the Prenatal Period

Abstract Objective We examined trajectories of stress, depression, and cannabis use across the prenatal period. We also investigated whether individuals who reported using cannabis to alleviate stress and depressive symptoms experienced symptom relief across the prenatal period. Methods Pregnant individuals (n=436) with a history of lifetime cannabis use were recruited and identified either as prenatal cannabis users (PCU; continued cannabis use following knowledge of pregnancy in the first trimester) or non-prenatal cannabis users (NPCU; no cannabis use following knowledge of pregnancy in the first trimester). PCU individuals additionally reported on reasons for continued cannabis use during pregnancy. We employed longitudinal multivariate modeling to examine trajectories of depression (maternal self-report; Edinburgh Postnatal Depression Scale), stress (maternal self-report; Perceived Stress Scale), and cannabis use (maternal self-report and urinalysis) over time, stratified by motives for use during the perinatal period. Results Stress, depression, and cannabis use decreased from the first to the third trimester (slope B= -0.21, -0.35, and -0.31, respectively). While cannabis use and depression at the first trimester were correlated with one another, they did not affect the other’s rate of change. Cannabis use similarly did not affect the rate of change in stress. Finally, while individuals using cannabis to cope with mental health symptoms experienced a decrease in overall depression symptoms, this slope was roughly equivalent to individuals who were not using cannabis prenatally (slope B= - 0.43 and -0.51, respectively). Conclusion Our sample experienced a collective decrease in depression, stress, and cannabis use prenatally. This decline in cannabis use – even among those who reported using to cope with mental health conditions – was not attributable to the decrease in depressive symptoms. This study lends valuable insight into the reasons why individuals continue to use cannabis during pregnancy, which providers can use to help tailor recommendations for other sources of coping and support to childbearing individuals.