title: Demographic, emotional and social determinants of cannabis use in early pregnancy: the Generation R study.
abstract: OBJECTIVE
  To ascertain demographic, emotional and social determinants of cannabis use in early pregnancy.
  
  
  METHODS
  This study was embedded in the Generation R study, a multiethnic population-based cohort of parents and their children, followed from pregnancy to childhood.
  
  
  METHODS
  Rotterdam, The Netherlands.
  
  
  METHODS
  Mothers enrolled in pregnancy who answered questions about their own and their partners substance use before and during pregnancy (n=7610).
  
  
  METHODS
  Using self-report questionnaires, information was collected on maternal demographics, psychopathology, delinquency, childhood trauma, social stress, family functioning, and parental alcohol, tobacco and substance use. Multinomial logistic regression analysis was used, with non-using women as reference.
  
  
  RESULTS
  246 (3.2%) women used cannabis before pregnancy and 220 (2.9%) women used cannabis both before and during pregnancy. The strongest determinant for maternal cannabis use during pregnancy was cannabis use by the biological father of the child (OR=38.56; 95%CI=26.14-58.88). Maternal cannabis use during pregnancy was also independently associated with being single (OR=4.25; 95%CI=2.33-7.75) or having a partner without being married (OR=2.75; 95%CI=1.56-4.85), childhood trauma (OR=1.39; 95%CI=1.22-1.57) and delinquency (OR=3.37; 95%CI=1.90-5.98), but not with maternal age, ethnicity, psychopathology, family functioning and perceived stress. Being religious was protective (Islam: OR=0.25; 95%CI=0.09-0.65) for maternal cannabis use during pregnancy. Additionally, lower educational level determined continued cannabis use in ever-users (OR=3.22; 95%CI=1.54-6.74).
  
  
  CONCLUSIONS
  Our results showed that multiple demographic, emotional and social characteristics were associated with maternal cannabis use. These characteristics should be considered when investigating offspring exposed to cannabis in utero, as they may play an important role in mother-child interaction and child development.
authors.affiliation: Generation R Study Group, Erasmus Medical Center Rotterdam, The Netherlands.
authors.forename: Hanan
authors.initials: H
authors.lastname: El Marroun
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
authors.forename: Anja C
authors.initials: AC
authors.lastname: Huizink
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology; D002188:Cannabis / Q000009:adverse effects*; D002648:Child; D004493:Education; D005006:Ethnicity; D005190:Family; D005260:Female; D006266:Health Education; D006801:Humans; D007182:Income; D002189:Marijuana Abuse / Q000453:epidemiology* / Q000523:psychology*; D017533:Marital Status; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy / Q000187:drug effects*; D011256:Pregnancy Outcome; D012067:Religion; D012907:Smoking / Q000453:epidemiology; D012931:Social Environment; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult