Maternal Cannabis Use in the Perinatal Period: Data From the Pregnancy Risk Assessment Monitoring System Marijuana Supplement, 2016–2018

Abstract

Objective: To estimate the prevalence of perinatal cannabis use (ie, before and/or during pregnancy); document the frequency, modes, and motivations for use; and identify predictors of perinatal cannabis use. Methods: Six states in the Pregnancy Risk Assessment Monitoring System, a state-specific, population-based surveillance system, administered a supplemental questionnaire on perinatal cannabis use in 2016-2018. Women with live births were surveyed 2-6 months postpartum about behaviors ≤ 3 months preconception and during pregnancy. Demographic, psychosocial, and behavioral characteristics were examined in relation to perinatal cannabis use using multinomial regression models. Those who: (1) never used cannabis, (2) only used in preconception period, and (3) used in both preconception and prenatal periods were compared. Results: Among 6428 respondents, 379 (5.8%) used cannabis preconceptionally only and 466 (4.4%) used in both the preconception and prenatal periods. Among those using prenatally, most reported smoking as their single mode (87.1%), with the two most common reasons being stress (83.8%) and nausea/vomiting (79.2%). Marital status, race/ethnicity, socioeconomic status, parity, and cigarette and alcohol use were significantly associated with perinatal cannabis use. Single (vs partnered) women were more likely to use cannabis prenatally (odds ratio = 2.4, 95% confidence interval: 1.5, 3.9) and non-Hispanic Black (vs White) women were less likely to use prenatally (odds ratio = 0.4, 95% confidence interval: 0.2, 0.8). Conclusions: Using a population-based sample of US births in six states, several demographic, psychosocial, and behavioral characteristics were identified in relation to perinatal cannabis use. These data are valuable for counseling in prenatal care and investigations of health effects.

Tobacco and Cannabis Use During and After Pregnancy in California

“…National data likely underestimate actual cannabis use during pregnancy, given concerns in communities where cannabis use is illegal that disclosure may result in being reported to child protective services (Woodruff et al, 2021 ). Nonetheless, nationally, it is estimated that 4.4% of women report cannabis use both before and during pregnancy (Sood et al, 2021 ). In states where recreational cannabis use is legal, 9.8% of women report cannabis use prior to pregnancy (Ko et al, 2020 ).…”

Impact of Tobacco and Marijuana on Infertility and Early Reproductive Wastage

“…In a study from the CDC's PRAMS, ∼4% of pregnant women selfreported use of marijuana in pregnancy across 6 states, most commonly for selfmanagement of nausea/vomiting or mental health. [73][74][75] However, on an individual state level, use in pregnancy ranges from 3% to 12%. 74 A survey from the National Survey on Drug Use and Health (NSDUH) from 2014 demonstrated that 3.9% of pregnant women reported marijuana use in the past month.…”

“…[73][74][75] However, on an individual state level, use in pregnancy ranges from 3% to 12%. 74 A survey from the National Survey on Drug Use and Health (NSDUH) from 2014 demonstrated that 3.9% of pregnant women reported marijuana use in the past month. 76 Reported prevalence ranges may be an underestimate, because of concerns about self-reporting use depending on legal concerns as well as concerns about implications of urine toxicology testing at the time of birth.…”

“…Marijuana use in pregnancy is increasingly common. In a study from the CDC’s PRAMS, ∼4% of pregnant women self-reported use of marijuana in pregnancy across 6 states, most commonly for self-management of nausea/vomiting or mental health 73–75. However, on an individual state level, use in pregnancy ranges from 3% to 12% 74.…”

Interpersonal Influences on the Choice to Treat Nausea during Pregnancy with Medication or Cannabis

“…5 Cannabis use during pregnancy is increasingly common, 6 and several studies show an association between nausea and vomiting during pregnancy and cannabis use. [7][8][9] The use of cannabis specifically as a treatment for nausea and vomiting during pregnancy is increasing, 6,10 and cannabis is the most used drug during pregnancy in the United States, 10,11 but little is known about how pregnant people make the choice to use cannabis or how interpersonal interactions influence this decision.…”