Importance Prenatal cannabis use continues to increase, yet studies of the demographic, psychiatric, and medical characteristics associated with cannabis use in pregnancy are limited by size and use of self-report, and often do not consider cannabis use disorder (CUD) or concomitant substance use disorders (SUDs). Understanding the factors associated with CUD in pregnancy is paramount for designing targeted interventions. Objective To examine the prevalence of co-occurring psychiatric and medical conditions of US pregnant individuals hospitalized with and without CUD by concomitant SUDs. Design, Setting, and Participants The study analyzed restricted hospital discharge data from the 2010 to 2018 Healthcare Cost and Utilization Project State Inpatient Databases in 35 states. Data were analyzed from January to August 2021. Weighted linear regressions tested whether the prevalence of psychiatric and medical conditions differed between individuals with and without a CUD diagnosis at hospitalization. Inpatient hospitalizations of pregnant patients aged 15 to 44 years with a CUD diagnosis were identified. Pregnant patients aged 15 to 44 years without a CUD diagnosis were identified for comparison. Patients were further stratified based on concomitant SUD patterns: (1) other SUDs, including at least 1 controlled substance; (2) other SUDs, excluding controlled substances; and (3) no other SUDs. Exposures CUD in pregnancy. Main Outcomes and Measures Prevalence of demographic characteristics, psychiatric disorders (eg, depression and anxiety), and medical conditions (eg, epilepsy and vomiting). Results The sample included 20 914 591 hospitalizations of individuals who were pregnant. The mean (SD) age was 28.24 (5.85) years. Of the total number of hospitalizations, 249 084 (1.19%) involved CUD and 20 665 507 (98.81%) did not. The proportion of prenatal hospitalizations involving CUD increased from 0.008 in 2010 to 0.02 in 2018. Analyses showed significant differences in the prevalence of almost every medical and psychiatric outcome examined between hospitalizations with and without CUD diagnoses, regardless of concomitant SUDs. Elevations were seen in depression (0.089; 95% CI, 0.083-0.095), anxiety (0.072; 95% CI, 0.066-0.076), and nausea (0.036; 95% CI, 0.033-0.040]) among individuals with CUD only at hospitalization compared with individuals with no SUDs at hospitalization. Conclusions and Relevance Considerable growth was observed in the prevalence of CUD diagnoses among individuals hospitalized prenatally and in the prevalence of depression, anxiety, nausea, and other conditions in individuals with CUD at hospitalization. This study highlights the need for more screening, prevention, and treatment, particularly in populations with co-occurring CUD and psychiatric disorders. Research on the determinants and outcomes associated with CUD during pregnancy is needed to guide clinicians, policy makers, and patients in making informed decisions.

中文翻译：

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妊娠期大麻使用障碍合并行为和医疗条件的关联。

重要性 产前大麻使用持续增加，但与怀孕期间使用大麻相关的人口统计、精神病学和医学特征的研究受到规模和使用自我报告的限制，并且通常不考虑大麻使用障碍 (CUD) 或伴随物质使用障碍（SUD）。了解与妊娠期 CUD 相关的因素对于设计有针对性的干预措施至关重要。目的 调查因伴随 SUD 而住院的有和没有 CUD 的美国孕妇同时发生的精神和医学状况的发生率。设计、设置和参与者 该研究分析了 35 个州的 2010 年至 2018 年医疗保健成本和利用项目州住院患者数据库中的受限出院数据。数据分析时间为 2021 年 1 月至 2021 年 8 月。加权线性回归测试了住院时有和没有 CUD 诊断的个体之间的精神病和医疗状况的患病率是否不同。确定了诊断为 CUD 的 15 至 44 岁怀孕患者的住院治疗。确定没有 CUD 诊断的 15 至 44 岁的孕妇进行比较。根据伴随的 SUD 模式对患者进行进一步分层：（1）其他 SUD，包括至少 1 种受控物质；(2) 其他 SUD，不包括受控物质；(3) 没有其他 SUD。在怀孕期间暴露 CUD。主要结果和措施 人口学特征、精神疾病（例如，抑郁和焦虑）和医疗状况（例如，癫痫和呕吐）的患病率。结果 样本包括 20 914 591 例住院孕妇。平均 (SD) 年龄为 28.24 (5.85) 岁。在住院总人数中，249 084 人（1.19%）涉及 CUD，20 665 507 人（98.81%）没有。涉及 CUD 的产前住院比例从 2010 年的 0.008 增加到 2018 年的 0.02。分析显示，无论是否伴随 SUD，在诊断为 CUD 的住院和未诊断为 CUD 的住院之间检查的几乎所有医学和精神科结果的患病率都有显着差异。在 CUD 仅在与住院时没有 SUD 的个体相比。结论和相关性 产前住院患者的 CUD 诊断患病率和住院 CUD 患者的抑郁、焦虑、恶心和其他疾病患病率显着增加。这项研究强调需要更多的筛查、预防和治疗，特别是在同时发生 CUD 和精神疾病的人群中。需要对妊娠期间与 CUD 相关的决定因素和结果进行研究，以指导临床医生、政策制定者和患者做出明智的决定。特别是在同时发生 CUD 和精神疾病的人群中。需要对妊娠期间与 CUD 相关的决定因素和结果进行研究，以指导临床医生、政策制定者和患者做出明智的决定。特别是在同时发生 CUD 和精神疾病的人群中。需要对妊娠期间与 CUD 相关的决定因素和结果进行研究，以指导临床医生、政策制定者和患者做出明智的决定。