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Principal Investigator: Ana M Abrantes
Organization: BUTLER HOSPITAL (PROVIDENCE, RI)
Fiscal Year: 2024
Award: $648,909
Funding agency: National Institute on Drug Abuse
Abstract
Cannabis is the most widely used drug among pregnant women, and rates of use are increasing
dramatically. Reasons for the sharp increase in cannabis use (CU) among in perinatal women are not clear.
Changes in cannabis legalization, increased access and acceptability of the drug, and a perception of low
health risk or therapeutic benefit are possible explanations. Increased CU for medicinal reasons in the general
population may prompt women to consider CU for pregnancy symptoms, such as nausea. Further, symptoms
of anxiety and depression are common during the perinatal period, and some women may turn to cannabis if it
is perceived to be less risky, or more acceptable, than standard psychopharmacologic treatments. Yet adverse
outcomes have been documented, including higher incidence of low birth weight, greater need for neonatal
intensive care admission, and a 3-fold risk of neonatal morbidity. Mothers who use cannabis prenatally
experience higher rates of depression; among postpartum users, there is also a greater risk for depression and
as well as lower likelihood of breastfeeding. Not all women who use cannabis prior to pregnancy continue
during the perinatal period. Some data suggest that 2/3 of women discontinue CU upon learning of pregnancy,
with up to 1/3 continuing use. Our data show that many women who continue CU express conflicted feelings
about their use. Among those who quit, relapse is not uncommon, especially after delivery. Reasons for
continued CU during the perinatal period, and motivations for cessation, are relatively unknown. In light of the
widespread CU during the perinatal period, a critical need exists to develop tailored interventions, services,
and educational materials, particularly addressing the needs of pregnant women with high levels of mood and
physical symptoms. However, before interventions and services can be developed, it is crucial to elucidate
pregnant women’s motives for CU, predictors of use and cessation, the extent to which mood and physical
symptoms drive patterns of use, as well as the salience of contextual factors (e.g., access to cannabis).
Utilizing a framework based on socioecological models of health behavior, we propose to examine factors that
contribute to women’s CU behavior in the perinatal period. In this 5-year study, we will recruit 200 pregnant
women who report regular CU immediately prior and/or during pregnancy and follow them from the first
trimester of pregnancy to 12 weeks postpartum. We include 4, 10-day bursts of ecological momentary
assessment (EMA) during the perinatal period to track associations between maternal mood and physical
symptoms, CU, and cannabis cravings. Further, we will conduct qualitative interviews with women to elicit
feedback regarding ideal content and modality of future services and interventions. Quantitative and qualitative
results will be integrated to yield cohesive findings to guide future research and service development. Tailored
support for women may reduce deleterious outcomes associated with CU during the perinatal period.
Terms: <1st trimester><Address><Admission><Admission activity><Anxiety><Application Context><Breast Feeding><Breast fed><Breastfed><Breastfeeding><Cannabis><Child Rearing><Data><Development><Drug usage><Drugs><Early Placental Phase><Ecological momentary assessment><Education><Educational Materials><Educational aspects><Emotional Depression><Family><Fatigue><Feedback><Feeling><First Pregnancy Trimester><First Trimester><Frequencies><Friends><Future><General Population><General Public><Gestation><Health><Health behavior><Hour><Incidence><Individual><Infant><Ingestion><Intervention><Intervention Strategies><Interview><Lack of Energy><Learning><Light><Link><Low Birth Weight Infant><Maintenance><Medical Marijuana><Medication><Medicinal Marijuana><Medicine><Mental Depression><Mental Health Services><Mental Hygiene Services><Methodology><Modality><Modeling><Moods><Mothers><Motivation><Nausea><Neonatal Intensive Care><Newborn Infant Intensive Care><Outcome><Pain><Painful><Parenting><Parenting behavior><Participant><Pattern><Perception><Pharmaceutical Preparations><Photoradiation><Population><Post-partum Women><Postpartum Period><Postpartum Women><Pregnancy><Pregnant Women><Relapse><Reporting><Research><Risk><Role><Services><Sleep disturbances><Social Environment><Social support><Stress><Symptoms><THC co-use><THC use><Tetrahydrocannabinol co-use><Tetrahydrocannabinol use><Therapeutic><Time><Woman><aberrant sleep><adverse consequence><adverse outcome><anxiety symptoms><anxious symptom><behavior prediction><behavioral prediction><cannabis cessation><cannabis craving><cannabis legalization><cannabis use><cannabis use behavior><cannabis use during pregnancy><cannabis use in pregnancy><cannabis use patterns><cannabis user><care giving burden><caregiving burden><caregiving stress><childrearing><contextual factors><coping><craving><depression><depression symptom><depressive><depressive symptoms><design><designing><developmental><disrupted sleep><disturbed sleep><drug use><drug/agent><expectant mother><expecting mother><feelings><health related behavior><impaired sleep><in vivo><ingest><interventional strategy><irregular sleep><legal marijuana><legalized cannabis><legalized marijuana><low birth weight><low birthweight><marijuana craving><marijuana legalization><marijuana use><marijuana use during pregnancy><marijuana use in pregnancy><marijuana user><medical cannabis><medicinal cannabis><mental health care><mental healthcare><mood symptom><negative affect><negative affectivity><neonatal morbidity><newborn morbidity><perinatal cannabis use><perinatal marijuana use><perinatal period><perinatal phase><perinatal women><physical symptom><post-partum><pregnant mothers><prenatal><prenatal cannabis use><prenatal experience><prenatal marijuana use><prospective><psychopharmacologic><psychopharmacological><recruit><risk perception><sleep difficulty><sleep disruption><sleep dysregulation><social climate><social context><social role><social support network><socioenvironment><socioenvironmental><standard care><standard treatment><therapeutic cannabis><therapeutic marijuana><unborn>