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

IF 5.2 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2024-07-31 DOI:10.1111/add.16622

Kelly C. Young-Wolff, Felicia W. Chi, Cynthia I. Campbell, Monique B. Does, Qiana L. Brown, Stacey E. Alexeeff, Deborah Ansley, Xiaoming Wang, Gwen T. Lapham

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Abstract

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.

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加利福尼亚州北部妊娠早期精神病和药物使用障碍与大麻使用和大麻使用障碍的关系。

目的：估计孕早期精神障碍与药物使用障碍（SUD）、大麻使用与大麻使用障碍（CUD）之间的关联强度：观察研究：参与者：2011 年 1 月至 2021 年 12 月期间（2020 年除外），在北加州凯泽医疗中心产前检查时，通过自我报告和尿液毒理学检测筛查了 227 555 名孕妇中的 299 496 名。样本中有 62.5% 为非白人，平均（标准差）年龄为 31.1 (5.5) 岁；6.8% 吸食大麻；0.2% 患有 CUD：暴露变量包括怀孕前两年至产前药物使用筛查日期前一天期间，基于电子健康记录的注意力缺陷多动症、焦虑症、双相情感障碍、抑郁症、人格障碍、创伤后应激障碍和精神病等精神病诊断；以及酒精、阿片类药物、兴奋剂和烟草使用障碍。结果变量包括任何大麻使用情况、自我报告的大麻使用频率以及孕早期的 CUD：精神病发病率从 0.2%（精神病）到 14.3%（焦虑）不等，药物滥用率从 0.3%（兴奋剂/类阿片）到 3.8%（烟草）不等。精神障碍与大麻使用和 CUD 相关，其中双相情感障碍与任何使用大麻的关系最为密切（调整后的几率比 [aOR] = 2.83；95% 置信区间 [CI] = 2.53-3.17），而精神病性障碍与 CUD 的关系最为密切（aOR = 10.01，95% CI = 6.52-15.37）。SUDs 与大麻使用和 CUD 相关，烟草使用障碍与任何使用相关性最强（aOR = 4.03，95% CI = 3.82-4.24），兴奋剂使用障碍与 CUD 相关性最强（aOR = 21.99，95% CI = 16.53-29.26）。焦虑症、双相情感障碍、抑郁障碍和烟草使用障碍与每天使用大麻的几率大于每月使用大麻或更少使用大麻有关：结论：精神障碍和药物使用障碍似乎与孕早期任何和频繁使用大麻以及大麻使用障碍的几率升高有关。在大多数情况下，药物使用障碍与大麻使用结果的相关性要强于其他精神障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.