(905) Association of prenatal cannabis use with severe depressive symptoms

To evaluate whether cannabis use during pregnancy is associated with depressive symptoms and if ongoing use influences those symptoms.

Study Design:

Ancillary of the nuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers to Be) study with participants enrolled October 2010-September 2013 at 8 academic centers. Individuals with pregnancy outcome data who completed the Edinburgh Postnatal Depression Scale (EPDS) and had available stored urine samples from early (6w0d - 13w6d) and late (22w0d – 29w6d) pregnancy study visits were included. Cannabis exposure was ascertained by urine immunoassay; positive results were confirmed with liquid chromatography tandem mass spectrometry. Cannabis exposure groups were: continued (both early and late), only-early, and none. The primary outcome was severe depressive symptoms (EPDS > 13) in late pregnancy. Early pregnancy EPDS > 13 was a secondary endpoint. The association of cannabis exposure and depressive symptoms was assessed with odds ratios from logistic regression adjusting for covariates, including history of mental health treatment.

Results:

Of 10,038 nuMoM2b participants, 8,280 met inclusion criteria, and 6% (n=492) were exposed to cannabis. Of those exposed, 3.2% (n=261) had only-early exposure and 2.8% (n=231) had continued exposure. Baseline characteristics differed between groups (Table). Early cannabis exposure was associated with early pregnancy EPDS >13 (aOR: 1.40 (1.02, 1.91)). Both only-early and continued exposure were associated with late pregnancy EPDS >13 in univariate comparisons; however only continued exposure remained significantly associated in multivariable modeling (aOR 1.78 95% CI 1.15 – 2.76) compared with no exposure (Figure).

Conclusion: Cannabis use and ongoing use throughout pregnancy was associated with severe depressive symptoms. Given that cessation of use after early pregnancy was not associated with depressive symptoms, cessation in pregnancy should continue to be encouraged.