Perinatal cannabis use and maternal experiences of severe nausea during pregnancy in Hawaii

Background: Recreational use of cannabis is relatively common in the United States, and medicinal use is increasingly gaining popular and legal support. Cannabis has been proposed as a potential treatment for hyperemesis gravidarum. Research into this topic is complicated by associations between cannabis use and poor birth outcomes. Cannabinoid hyperemesis syndrome, which can cause severe nausea and vomiting in cannabis users, is another complicating factor. Methods: Hawaii Pregnancy Risk Assessment Monitoring System (PRAMS) data from 4735 respondents were used to estimate prevalence of self-reported cannabis use during and in the month before pregnancy, as well as severe nausea during pregnancy. Data were weighted to be representative of all pregnancies resulting in live births in Hawaii between 2009 and 2011. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were computed to estimate associations. Results: Of recently-pregnant women in Hawaii, 6% reported using cannabis in the month before their most recent pregnancy, and 2.6% reported using cannabis during pregnancy. Approximately 21% reported severe nausea during pregnancy. Women who reported severe nausea during pregnancy were more likely to report cannabis use before (7% vs. 5.5%; PR=1.27, 95%CI 0.94-1.72) and during (3.7% vs. 2.3%; PR=1.63, 95%CI 1.08-2.44) pregnancy. Discussion: Hawaii women who reported severe nausea during pregnancy were more likely to report cannabis use both during and before pregnancy. Cannabis use as a natural anti-emetic has been reported elsewhere. More research is needed to investigate the relationship between cannabis use and severe nausea during pregnancy, and to quantify associated risks to mother and fetus.