Mental Health
Cannabis Use Disorder and Postpartum Serious Mental Disorders: Trends and Associations Among Delivering Women in California, 2016-2021 Tosin Oyetunji* LaMecia Ward Ward Ward University California of Merced
Substance use during pregnancy remains a major public health concern due to its association with fetal and maternal health risks, including mental health problems. Since recreational cannabis was legalized in California in 2016 and use has risen, it is critical to examine how prenatal cannabis use is associated with postpartum women’s mental health. Using California statewide linked data on inpatient hospital deliveries and emergency department (ED) visits from January 2016 to December 2021, we examined risk of any ED visit for a serious mental disorder (SMD; psychotic, bipolar, major depressive, anxiety disorders, or suicidal ideation) within 12 months postpartum. Exposure groups were defined as women with cannabis use disorder (CUD), alcohol use disorder (AUD), or neither AUD/CUD, assessed at delivery. Risk ratio (RR) models adjusted for age group, race/ethnicity, insurance type, urbanicity, comorbid psychotic, mood, or anxiety disorder diagnoses at delivery, number of ED visits during pregnancy, and tobacco/nicotine use. Trend analyses showed the prevalence of CUD at delivery increased by 6% per year, and that of AUD increased by 3% per year. Compared with those with no AUD/CUD, individuals with CUD at delivery had 30% higher risk of postpartum SMD (RRadj=1.30; 95% CI:1.21-1.39), while those with AUD had 46% higher risk (RRadj=1.46; 95% CI:1.20-1.77). Findings suggest that prenatal CUD and AUD are independently associated with postpartum serious mental disorder burden, with AUD associated with a slightly higher risk. However, given the substantial rise and increasing prevalence of CUD over time among delivering individuals, CUD may signal a growing mental health threat in this population. These findings highlight the need for intervention and screening strategies for prenatal substance use and mental health.