Abstract
Introduction The prevalence of cannabis use during pregnancy has risen alongside its legalization and perceived safety, often being used to alleviate pregnancy-related discomforts. However, cannabis use during pregnancy may have adverse implications for maternal mental health, including increased rates of depression, panic disorder, suicidal ideation, and alcohol abuse. This study aims to evaluate the association between cannabis use during pregnancy and these mental health outcomes. Methods This retrospective cohort study utilized the TriNetX database, including over 2 million pregnant patients from 69 U.S. healthcare organizations (HCOs). A cohort of 51,087 cannabis users during pregnancy was compared to 1,936,508 non-users. Outcomes analyzed included depression, panic disorder, suicidal ideation, and alcohol abuse, identified using the International Classification of Diseases, 10th Revision (ICD-10) codes. Risk ratios, hazard ratios, and Kaplan-Meier survival probabilities were calculated, with statistical significance set at p < 0.05. Results Cannabis use during pregnancy was associated with higher incidences of all four mental health outcomes. Alcohol abuse showed the greatest relative risk (risk ratio = 13.57; hazard ratio = 12.44), followed by suicidal ideation (risk ratio = 10.67; hazard ratio = 9.81), panic disorder (risk ratio = 5.47; hazard ratio = 5.01), and depression (risk ratio = 2.66; hazard ratio = 3.50). Depression affected 29.7% of cannabis users, compared to 11.2% of non-users, with significant differences in survival probabilities (p < 0.001). Conclusion Cannabis use during pregnancy is significantly associated with increased risks of adverse mental health outcomes. These findings emphasize the importance of screening for cannabis use and mental health conditions during pregnancy and underscore the need for public health initiatives addressing the risks of prenatal cannabis use. Further research is needed to explore causal relationships and dosing effects.