Cannabis and Pregnancy: A Psychiatric, Medical, or General Population Issue?

Background: Cannabis use during pregnancy may adversely affect the health of pregnant women and their fetus. Several recent surveys led in the US general population in the last decade showed an increase in cannabis use during pregnancy from 1.95 to 7%, with a 0.5% for medical-only purposes. Objectives: Our aim was to investigate if an increased incidence might be due to a greater public acceptability after introduction of cannabis medical use or due to psychiatric implications and unmet needs. Method: 500 pregnant women (302 psychiatric patients and 198 healthy controls) were tested with the Edimburgh Post-Natal Depression Scale, Beck Anxiety and Depression Inventory, and Structured Clinical Interview for the DSM-IV Axis II while substance use disorder was documented with the fulfillment of the DSM-5 criteria. Results: Five percent of the whole sample had a documented addiction to cannabis during pregnancy (all among psychiatric patients and none in the general population). All psychiatric patients with cannabis use disorder were affected by borderline personality disorder, except for 1 patient with cannabis and cocaine use disorders who suffered from adjustment disorder with anxiety. Conclusions: Addiction to cannabis during pregnancy has an increased rate confirming surveys on the general US population but seem entirely linked to psychiatric issues, especially borderline personality disorder. Personality disorders may have been underestimated in surveys in the general population until now because these are usually not assessed.