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.

摘要 大麻是孕妇中使用最广泛的药物，而且使用率正在上升 戏剧性的。围产期妇女中大麻使用量急剧增加的原因尚不清楚。 大麻合法化的变化，更多地获得和接受毒品，以及对大麻的看法较低 健康风险或治疗益处是可能的解释。总体上因医学原因而增加的CU 人群可能会促使女性考虑对怀孕症状进行CU治疗，如恶心。此外，症状 焦虑和抑郁在围产期是常见的，一些妇女可能会转向大麻，如果它 被认为比标准的精神药理学治疗风险更低，或更容易接受。然而，不利的 结果已经被记录下来，包括低出生体重的发生率更高，对新生儿的需求更大 重症监护入院，新生儿发病率增加3倍。产前使用大麻的母亲 经历更高的抑郁率；在产后使用者中，也有更大的抑郁风险和 以及较低的母乳喂养可能性。并非所有怀孕前吸食大麻的女性都会继续吸食大麻 在围产期。一些数据表明，三分之二的女性在得知怀孕后停止了CU， 高达1/3的持续使用。我们的数据显示，许多继续CU的女性表达了相互矛盾的感觉 关于它们的用途。在戒毒者中，复发并不少见，特别是在分娩后。原因： 围产期持续的CU和停止的动机相对未知。鉴于 在围产期普遍存在CU，迫切需要制定量身定制的干预措施、服务、 和教育材料，特别是针对情绪高涨的孕妇和 身体症状。然而，在制定干预措施和服务之前，至关重要的是阐明 孕妇使用CU的动机、使用和停药的预测因素、情绪和身体状况的程度 症状驱动使用模式，以及背景因素的突出程度(例如，获得大麻)。 利用一个基于健康行为的社会生态学模型的框架，我们建议检查以下因素 有助于女性围产期的CU行为。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/或怀孕期间立即报告常规CU并从第一次开始跟踪的妇女 怀孕三个月至产后12周。我们包括4，10天的生态瞬间爆发 围产期评估(EMA)以跟踪母亲情绪和身体之间的关系 症状，慢性精神分裂症和对大麻的渴望。此外，我们将对女性进行定性采访，以引发 关于未来服务和干预的理想内容和方式的反馈。量与质 结果将被整合，以产生一致的结果，以指导未来的研究和服务开发。量身定做 对妇女的支持可能会减少围产期CU相关的有害后果。