AIMS We aimed to determine the association between stressful life events (SLEs) in the year prior to childbirth with (1) pre-pregnancy cannabis use, (2) cessation of cannabis use during pregnancy, and (3) postpartum relapse to cannabis use. DESIGN We used data from the Pregnancy Risk Assessment Monitoring System (PRAMS), 2016, a cross-sectional, population-based surveillance system. SETTING Mailed and telephone surveys conducted in five states - Alaska, Colorado, Maine, Michigan and Washington - in the United States. PARTICIPANTS Women (n=6061) who delivered a live infant within the last 6 months and had data on cannabis use. MEASUREMENTS Self-reported data included SLEs (yes/no response for 14 individual events in the 12 months prior to childbirth) and cannabis use (yes/no prior to pregnancy, during pregnancy, and at the time of the survey [approximately 2-6 months postpartum]). The associations between SLEs and cannabis use (primary outcomes) were examined in logistic regression models adjusted for maternal demographics (e.g., age, race, education), geography (i.e., state of residence) and cigarette smoking. FINDINGS Pre-pregnancy, 16.4% (997/6061) of respondents endorsed using cannabis, with 36.4% (363/997) continuing cannabis use during pregnancy. Among the 63.6% (634/997) who did not report use during pregnancy, 23.2% (147/634) relapsed to cannabis use during the postpartum. Nine of the 14 possible SLEs were associated with increased odds of pre-pregnancy cannabis use (e.g., husband/partner or mother went to jail aOR: 2.16, 95% CI:1.30-3.62) and four were associated with increased odds of continued cannabis use during pregnancy (e.g., husband/partner lost job aOR: 2.19, 95% CI: 1.21-3.96). The odds of postpartum relapse to cannabis were significantly associated with 2 SLEs (husband/partner said they didn't want pregnancy aOR: 2.86 CI: 1.10-7.72; husband/partner or mother went to jail aOR: 0.37, 95% CI: 0.13-1.00). CONCLUSIONS Stressful life events during the year prior to childbirth appear to be linked to greater odds of women's cannabis use during the perinatal period, especially during pre-pregnancy.

中文翻译：

---

围产期大麻使用和压力性生活事件：妊娠风险评估监测系统 (PRAMS) 数据的横截面结果，2016

目的 我们旨在确定分娩前一年的压力性生活事件 (SLE) 与 (1) 孕前吸食大麻、(2) 怀孕期间停止吸食大麻和 (3) 产后再次吸食大麻之间的关联。设计 我们使用了来自 2016 年妊娠风险评估监测系统 (PRRAMS) 的数据，这是一个基于人群的横断面监测系统。设置 在美国的五个州——阿拉斯加、科罗拉多、缅因、密歇根和华盛顿——进行了邮寄和电话调查。参与者 妇女 (n=6061) 在过去 6 个月内分娩过一个活婴儿并拥有大麻使用数据。测量 自我报告的数据包括 SLE（对分娩前 12 个月内的 14 起个体事件有反应/无反应）和大麻使用（怀孕前、怀孕期间是/否、并且在调查时 [大约产后 2-6 个月]）。SLE 与大麻使用（主要结果）之间的关联在逻辑回归模型中进行了检查，该模型针对产妇人口统计数据（例如年龄、种族、教育）、地理（即居住状态）和吸烟情况进行了调整。调查结果 怀孕前，16.4% (997/6061) 的受访者支持使用大麻，36.4% (363/997) 在怀孕期间继续使用大麻。在怀孕期间未报告使用大麻的 63.6% (634/997) 中，23.2% (147/634) 在产后再次使用大麻。14 种可能的 SLE 中有 9 种与孕前使用大麻的几率增加有关（例如，丈夫/伴侣或母亲入狱 aOR：2.16，95% CI：1.30-3.62），4 种与继续使用大麻的几率增加有关怀孕期间使用（例如，丈夫/伴侣失业 aOR：2.19，95% CI：1.21-3.96）。产后复吸大麻的几率与 2 个 SLE 显着相关（丈夫/伴侣说他们不想怀孕 aOR：2.86 CI：1.10-7.72；丈夫/伴侣或母亲入狱 aOR：0.37，95% CI：0.13 -1.00)。结论 分娩前一年的压力生活事件似乎与围产期妇女使用大麻的几率增加有关，尤其是在怀孕前。