Association of psychiatric and substance use disorders with cannabis use and cannabis use disorder during early pregnancy in northern California.

Autor: Young-Wolff KC; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA., Chi FW; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA., Campbell CI; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA., Does MB; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA., Brown QL; School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA., Alexeeff SE; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA., Ansley D; Regional Offices, Kaiser Permanente Northern California, Oakland, CA, USA., Wang X; Center of Clinical Trials Network, National Institute on Drug Abuse, NIH, Bethesda, MD, USA., Lapham GT; Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA.; Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA.
Jazyk: angličtina
Zdroj: Addiction (Abingdon, England) [Addiction] 2024 Nov; Vol. 119 (11), pp. 1987-1997. Date of Electronic Publication: 2024 Jul 31.
DOI: 10.1111/add.16622
Abstrakt: Aims: To estimate the strength of association between psychiatric disorders and substance use disorders (SUD), and cannabis use and cannabis use disorder (CUD) during early pregnancy.
Design: Observational study.
Setting: Kaiser Permanente Northern California, USA.
Participants: 299 496 pregnancies from 227 555 individuals screened for cannabis use by self-report and a urine toxicology test at entrance to prenatal care in Kaiser Permanente Northern California during January 2011-December 2021 (excepting year 2020). The sample was 62.5% non-White, with a mean (standard deviation) age of 31.1 (5.5) years; 6.8% used cannabis; 0.2% had a CUD.
Measurements: Exposure variables included electronic health record-based psychiatric diagnoses of attention deficit hyperactivity, anxiety, bipolar, depressive, personality, posttraumatic stress and psychotic disorders; and alcohol, opioid, stimulant and tobacco use disorders, during the two years prior to pregnancy up to the day before the prenatal substance use screening date. Outcome variables were any cannabis use, frequency of self-reported cannabis use and CUD during early pregnancy.
Findings: Psychiatric disorder prevalence ranged from 0.2% (psychotic) to 14.3% (anxiety), and SUD ranged from 0.3% (stimulant/opioid) to 3.8% (tobacco). Psychiatric disorders were associated with cannabis use and CUD, with the strongest association for any use found for bipolar disorder (adjusted odds ratio [aOR] = 2.83; 95% confidence interval [CI] = 2.53-3.17) and the strongest association for CUD found for psychotic disorders (aOR = 10.01, 95% CI = 6.52-15.37). SUDs were associated with cannabis use and CUD, with the strongest association for any use found for tobacco use disorder (aOR = 4.03, 95% CI = 3.82-4.24) and the strongest association for CUD found for stimulant use disorder (aOR = 21.99, 95% CI = 16.53-29.26). Anxiety, bipolar, depressive disorders and tobacco use disorder were associated with greater odds of daily than monthly or less cannabis use.
Conclusions: Psychiatric disorders and substance use disorders appear to be associated with elevated odds of any and frequent cannabis use as well as cannabis use disorder during early pregnancy. In most cases, the associations with cannabis outcomes were stronger for substance use disorders than other psychiatric disorders.
(© 2024 Society for the Study of Addiction.)
Databáze: MEDLINE
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