GESTATIONAL CANNABIS USE and MATERNAL DOMESTIC VIOLENCE before and since the COVID-19 PANDEMIC in AN AUSTRALIAN TERTIARY LEVEL ANTENATAL SERVICE

ABSTRACT

Background: Recent studies describe increasing rates of cannabis use among pregnant women. Gestational cannabis use has been associated with adverse neonatal outcomes and maternal reports of domestic violence. Domestic violence reportedly increased in Australia during the COVID-19 pandemic. We examined trends and outcomes of gestational cannabis use before and during the COVID-19 pandemic and sought associations with domestic violence. Method(s) The study population comprised women who attended the antenatal clinic and childbirth between 1 January 2019 and 31 December 2021 at an Australian tertiary hospital. Maternal socio-demographic, pregnancy progress and neonatal outcomes were recorded from the clinical records. We sought associations between maternal cannabis use and self-reported domestic violence during the study period, and the relationship with pregnancy outcomes. Result(s) Cannabis use was reported by 165/10,263 (1.6%) pregnant women. Cannabis use remained consistent during the study period, but reports of domestic violence increased from 2.9% pre-COVID to 6.7% during the COVID-19 pandemic. During the pandemic, women with gestational cannabis use were more likely to be young (40% <25 years vs. 11.8% .25 years), underweight (3.5% vs. 2.4%) and reported more domestic violence (33.0% vs. 6.3%), compared with non-users. The most common co-consumed substances by cannabis-users were tobacco (63.5%), alcohol (13.9%) and amphetamines (9.6%). Gestational cannabis use was associated with smaller neonates (median birth weight 2900 vs. 3330 g), higher preterm births (33% vs. 8.6%) and increased stillbirths (1.7% vs. 0.4%) Conclusion(s) Although domestic violence increased, gestational cannabis use remained constant during the COVID-19 pandemic and was associated with worse neonatal outcomes.