Mental Health, Substance Use, Sociodemographic, and Attitudinal Correlates of Marijuana Use During Pregnancy, NSDUH 2014 Open Access

Koola, Catherine (2016)

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Background: Marijuana is the most common illicit drug used during pregnancy in the United States with a significant increase in prenatal use from 2002 to 20131-5. Noting the ongoing legalization of marijuana among U.S. states, the gaps in literature require a more specific examination of comorbid mental health conditions associated with marijuana use during pregnancy.

Objective: The purpose of this study is to investigate whether an association exists between marijuana use during pregnancy and having serious psychological distress among females of reproductive age in the United States, when adjusting for other sociodemographic, substance use, mental health, and attitudinal factors.

Methods: Data from NSDUH 2014, a cross-sectional nationally representative survey, identified pregnant women aged 12-44 years self-reporting marijuana use in the past month (4.5%, weighted n=103,582) and self-reporting no use of marijuana in the past month (95.5%, weighted n=2,223,191). Weighted descriptive frequencies and a multiple logistic regression analysis were conducted using specialized survey procedures in SAS 9.4 statistical software.

Results: When adjusting for maternal age, trimester, cigarette use, perceived risk of smoking marijuana, and depression, pregnant women who had serious psychological distress in the past month had increased odds of using marijuana in the past month (OR=6.667, 95% CI: 1.148 - 38.707) when compared to pregnant women who did not have serious psychological distress. Cigarette use in the past month was the most significant correlate (p<0.0001) of marijuana use in the past month among pregnant women (OR=12.443, 95% CI: 3.822 - 40.512) when adjusting for all other correlates in the final model, while age, trimester, and perceived risk of smoking marijuana were also significant correlates of prenatal marijuana use in the adjusted model.

Conclusion: The results from this study characterize cigarette use in the past month and psychological distress in the past month as the two most significant correlates of prenatal marijuana use. Although inconclusive, previous research posits a range of poor birth outcomes and fetal developmental deficits potentially associated with prenatal marijuana use. Therefore, addressing comorbid mental health and substance use conditions may be helpful in reducing marijuana use during pregnancy while further research is required to more fully understand the short-term and long-term outcomes of prenatal marijuana use.

Table of Contents

Chapter I: Introduction

a. Introduction and Rationale

b. Statement of Need

c. Research Question and Hypotheses

Chapter II: Literature Review

a. Pregnancy-related Terminology

b. Fetal Outcomes

c. Epidemiology of Marijuana Use During Pregnancy

d. Trimester and Duration of Use

e. Sociodemographic Correlates: Age, Race, Education, Employment, Marital Status

f. Other Correlates

g. Comorbid Marijuana Use and Mental Illness

h. Current Problem and Study Relevance

Chapter III: Methodology

a. Research design

b. Overview of National Survey on Drug Use and Health

c. Target Population and Sample

d. Instrument and Data Collection

e. Data Retrieval

f. Limitations

g. Delimitation

h. Data Selection and Variable Coding

i. Data Analysis Procedures

j. IRB Clearance

Chapter IV: Results

a. Study Population

b. Sociodemographic Characteristics Stratified by Outcome

c. Trimester Stratified by Outcome

d. Substance Use Characteristics Stratified by Outcome

e. Mental Health Characteristics Stratified by Outcome

f. Attitudes Stratified by Outcome

g. Multiple Logistic Regression Analysis

Chapter V: Discussion

a. Study Strengths and Limitations

b. Implications for Prenatal Substance Use and Public Health

c. Directions for Future Research

d. Conclusion

Appendix I: References

Appendix II: Detailed Data Analysis Methods and Results

Appendix III: Tables

Appendix IV: SAS Code

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