Before and After Legalization: Cannabis Use Among Pregnant Patients at a Tertiary Care Centre in Ontario

Smith, Graeme N.; Drabkin, Meriah; Pudwell, Jessica

doi:10.1016/j.jogc.2022.03.014

Journal of Obstetrics and Gynaecology Canada

2022

DOI: 10.1016/j.jogc.2022.03.014

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Before and After Legalization: Cannabis Use Among Pregnant Patients at a Tertiary Care Centre in Ontario

Graeme N. Smith

Meriah Drabkin

Jessica Pudwell

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“… 7 Another single-centre study from Ontario, which included 149 pregnancies, found no significant change in the proportion of pregnancies that tested positive for cannabis via urine drug screen in the first year after legalization. 8 Findings from the US are mixed; a study found higher odds of cannabis use in states where it is legal than in states in which use is illegal, 9 but another found that increases over time in cannabis use during pregnancy did not differ by the state’s legal status. 10 Although literature suggests that pregnant people commonly use cannabis during pregnancy to alleviate symptoms of morning sickness, the risk factors that are associated with heavy cannabis use or cannabis use disorders during pregnancy are poorly understood.…”

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confidence: 99%

Acute care related to cannabis use during pregnancy after the legalization of nonmedical cannabis in Ontario

Myran

Roberts

Pugliese

et al. 2023

CMAJ

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Background: Cannabis use during pregnancy is increasing, but the contribution of cannabis legalization to these trends is unclear. We sought to determine whether health service utilization related to cannabis use during pregnancy increased after the legalization of nonmedical cannabis in October 2018 in Ontario, Canada. Methods: In this population-based, repeated cross-sectional study, we evaluated changes in the number of pregnant people who received acute care (emergency department visit or admission to hospital) between January 2015 and July 2021 among all people eligible for the province’s public health coverage. We used segmented regression to compare changes in the quarterly rate of pregnant people with acute care related to cannabis use (primary outcome) with the quarterly rates of acute care for mental health conditions or for noncannabis substance use (control conditions). We identified risk factors associated with acute care for cannabis use and the risk of adverse neonatal outcomes using multivariable logistic regression models. Results: The mean quarterly rate of acute care for cannabis use during pregnancy increased from 11.0 per 100 000 pregnancies before legalization to 20.0 per 100 000 pregnancies after legalization (incidence rate ratio [IRR] 1.82, 95% confidence interval [CI] 1.44–2.31), while acute care for mental health conditions decreased (IRR 0.86, 95% CI 0.78–0.95) and acute care for noncannabis substance use did not change (IRR 1.03, 95% CI 0.91–1.17). Legalization was not associated with an immediate change, but the quarterly change in rates of pregnancies with acute care for cannabis use increased by 1.13 (95% CI 0.46–1.79) per 100 000 pregnancies after legalization. Pregnant people with acute care for cannabis use had greater odds of having received acute care for hyperemesis gravidarum during their pregnancy than those without acute care for cannabis use (30.9% v. 2.5%, adjusted odds ratio [OR] 9.73, 95% CI 8.01–11.82). Pregnancies with acute care for cannabis use had greater odds of newborns being born preterm (16.9% v. 7.2%, adjusted OR 1.93, 95% CI 1.45–2.56) and of requiring care in the neonatal intensive care unit (31.5% v. 13.0%, adjusted OR 1.94 95% CI 1.54–2.44) than those without acute care for cannabis use. Interpretation: The rate of acute care related to cannabis use during pregnancy almost doubled after legalization of nonmedical cannabis, although absolute increases were small. These findings highlight the need to consider interventions to reduce cannabis use during pregnancy in jurisdictions pursuing legalization.

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confidence: 99%

Acute care related to cannabis use during pregnancy after the legalization of nonmedical cannabis in Ontario

Myran

Roberts

Pugliese

et al. 2023

CMAJ

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Evaluation of the Association Between Prenatal Cannabis Use and Risk of Developmental Delay

Watts,

Lebel,

Chaput

et al. 2024

JAACAP Open

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Before and After Legalization: Cannabis Use Among Pregnant Patients at a Tertiary Care Centre in Ontario

Cited by 2 publications

References 8 publications

Acute care related to cannabis use during pregnancy after the legalization of nonmedical cannabis in Ontario

Acute care related to cannabis use during pregnancy after the legalization of nonmedical cannabis in Ontario

Evaluation of the Association Between Prenatal Cannabis Use and Risk of Developmental Delay

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