A Longitudinal EMA Study Examining the Role of Maternal Mood and Physical Symptoms on Women's Cannabis Use Across the Perinatal Period

一项纵向 EMA 研究，探讨母亲情绪和身体症状对女性围产期大麻使用的影响

• 批准号: 10802562
• 负责人: Ana M Abrantes
• 金额: $ 69.02万
• 依托单位: BUTLER HOSPITAL (PROVIDENCE, RI)
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10802562
• 关键词: Address; Admission activity; Anxiety; Breast Feeding; Cannabis; Child Rearing; Data; Development; Drug usage; Ecological momentary assessment; Education; Educational Materials; Family; Fatigue; Feedback; Feeling; First Pregnancy Trimester; Frequencies; Friends; Future; General Population; Health; Health behavior; Hour; Incidence; Individual; Infant; Ingestion; Intervention; Interview; Learning; Light; Link; Low Birth Weight Infant; Maintenance; Medical Marijuana; Medicine; Mental Depression; Mental Health Services; Methodology; Modality; Modeling; Moods; Mothers; Motivation; Nausea; Neonatal Intensive Care; Outcome; Pain; Participant; Pattern; Perception; Pharmaceutical Preparations; Population; Postpartum Period; Postpartum Women; Pregnancy; Pregnant Women; Relapse; Reporting; Research; Risk; Role; Services; Sleep disturbances; Social Environment; Social support; Stress; Symptoms; Therapeutic; Time; Woman; adverse outcome; anxiety symptoms; behavior prediction; cannabis cessation; cannabis craving; cannabis use behavior; care giving burden; contextual factors; coping; craving; depressive symptoms; design; in vivo; marijuana legalization; marijuana use; marijuana use in pregnancy; marijuana user; mood symptom; negative affect; neonatal morbidity; perinatal cannabis use; perinatal period; perinatal women; physical symptom; prenatal; prenatal experience; prospective; psychopharmacologic; recruit; risk perception; sleep difficulty; standard care

Abstract Cannabis is the most widely used drug among pregnant women, and rates of use are increasing dramatically. Reasons for the sharp increase in cannabis use (CU) among in perinatal women are not clear. Changes in cannabis legalization, increased access and acceptability of the drug, and a perception of low health risk or therapeutic benefit are possible explanations. Increased CU for medicinal reasons in the general population may prompt women to consider CU for pregnancy symptoms, such as nausea. Further, symptoms of anxiety and depression are common during the perinatal period, and some women may turn to cannabis if it is perceived to be less risky, or more acceptable, than standard psychopharmacologic treatments. Yet adverse outcomes have been documented, including higher incidence of low birth weight, greater need for neonatal intensive care admission, and a 3-fold risk of neonatal morbidity. Mothers who use cannabis prenatally experience higher rates of depression; among postpartum users, there is also a greater risk for depression and as well as lower likelihood of breastfeeding. Not all women who use cannabis prior to pregnancy continue during the perinatal period. Some data suggest that 2/3 of women discontinue CU upon learning of pregnancy, with up to 1/3 continuing use. Our data show that many women who continue CU express conflicted feelings about their use. Among those who quit, relapse is not uncommon, especially after delivery. Reasons for continued CU during the perinatal period, and motivations for cessation, are relatively unknown. In light of the widespread CU during the perinatal period, a critical need exists to develop tailored interventions, services, and educational materials, particularly addressing the needs of pregnant women with high levels of mood and physical symptoms. However, before interventions and services can be developed, it is crucial to elucidate pregnant women’s motives for CU, predictors of use and cessation, the extent to which mood and physical symptoms drive patterns of use, as well as the salience of contextual factors (e.g., access to cannabis). Utilizing a framework based on socioecological models of health behavior, we propose to examine factors that contribute to women’s CU behavior in the perinatal period. In this 5-year study, we will recruit 200 pregnant women who report regular CU immediately prior and/or during pregnancy and follow them from the first trimester of pregnancy to 12 weeks postpartum. We include 4, 10-day bursts of ecological momentary assessment (EMA) during the perinatal period to track associations between maternal mood and physical symptoms, CU, and cannabis cravings. Further, we will conduct qualitative interviews with women to elicit feedback regarding ideal content and modality of future services and interventions. Quantitative and qualitative results will be integrated to yield cohesive findings to guide future research and service development. Tailored support for women may reduce deleterious outcomes associated with CU during the perinatal period.

抽象的 大麻是孕妇中使用最广泛的药物，并且使用率正在增加 围产期妇女吸食大麻 (CU) 急剧增加的原因尚不清楚。 大麻合法化的变化、药物的获取和可接受性的增加以及人们对大麻合法化程度低的看法 一般而言，健康风险或治疗益处是由于医学原因导致 CU 增加的可能原因。 人群可能会促使女性考虑使用 CU 治疗妊娠症状，例如恶心症状。 焦虑和抑郁在围产期很常见，一些女性可能会转向大麻，如果 被认为比标准的精神药物治疗风险更小，或更容易接受，但不利。 结果已被记录，包括低出生体重发生率更高、对新生儿的需求更大 产前使用大麻的母亲新生儿发病风险增加 3 倍。 抑郁症发生率较高；产后使用者患抑郁症的风险也较高 并非所有在怀孕前使用大麻的女性都会继续母乳喂养。 一些数据表明，2/3 的女性在得知怀孕后就停止使用 CU， 高达 1/3 的持续使用者表示，许多继续使用 CU 的女性表达了矛盾的感受。 在戒烟者中，复发并不罕见，尤其是在分娩后。 鉴于围产期持续使用 CU 以及停止使用的动机相对未知。 由于围产期 CU 广泛存在，迫切需要制定量身定制的干预措施、服务、 和教育材料，特别是满足情绪高涨的孕妇的需求 然而，在制定干预措施和服务之前，阐明这一点至关重要。 孕妇使用 CU 的动机、使用和停止的预测因素、情绪和身体状况的影响程度 症状决定了使用模式以及背景因素的重要性（例如，获取大麻）。 利用基于健康行为社会生态模型的框架，我们建议研究以下因素： 在这项为期 5 年的研究中，我们将招募 200 名孕妇。 在怀孕前和/或怀孕期间定期报告 CU 并从一开始就跟踪的女性 怀孕三个月到产后 12 周，我们包括 4 次、为期 10 天的生态瞬时爆发。 围产期评估（EMA），追踪母亲情绪与身体状况之间的关联 此外，我们将对女性进行定性访谈以引出。 关于未来服务和干预的理想内容和方式的反馈。 结果将被整合以产生有凝聚力的发现，以指导未来的研究和服务开发。 对妇女的支持可能会减少围产期与 CU 相关的有害后果。