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The American Journal of Drug and Alcohol Abuse
Encompassing All Addictive Disorders
Volume 48, 2022 - Issue 6
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Original Article

Cannabis use among pregnant women under different legalization frameworks in the United States

Kathak Vachhania Temerty Faculty of Medicine, University of Toronto, Toronto, ON, CanadaCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-9869-1027View further author information
ORCID Icon,
Andrea N. Simpsona Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada;b Department of Obstetrics and Gynecology, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada;c Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada;d Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, CanadaCorrespondence[email protected]
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,
Duminda N. Wijeysunderaa Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada;c Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada;d Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada;e Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada;f Department of Anesthesia, St. Michael’s Hospital, Toronto, ON, CanadaView further author information
,
Hance Clarkea Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada;c Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada;g Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, CanadaView further author information
&
Karim S. Ladhaa Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada;c Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada;d Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada;e Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada;f Department of Anesthesia, St. Michael’s Hospital, Toronto, ON, CanadaView further author information
Pages 695-700 | Received 17 Feb 2022, Accepted 11 Oct 2022, Published online: 28 Nov 2022
 
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ABSTRACT

Background: Cannabis use in pregnancy is associated with adverse neonatal outcomes, yet its use among pregnant women in the United States has increased significantly.

Objectives: This cross-sectional study explored how cannabis use in pregnant women varied between different cannabis legalization frameworks, that is, permitted use of cannabidiol (CBD)-only, medical cannabis, and adult-use cannabis.

Methods: Behavioral Risk Factor Surveillance System data from 2017 to 2020 was utilized with respondents classified by their state’s policies into CBD-only, medical, and adult-use groups. Outcome measures included prevalence of use and usage characteristics (frequency, method of intake, and reason for use) among pregnant women. Logistic regression models were estimated to evaluate the association between legal status and prevalence of use.

Results: The unweighted dataset included 1,992 pregnant women. Recent cannabis use was reported by (weighted proportions): 2.4% (95%CI: 0–4.4) of respondents in the CBD-only group, 7.1% (95%CI: 4.0–10.1) in the medical group and 6.9% (95%CI: 3.0–10.9) in the adult-use group. Compared to the CBD-only group, respondents in the medical and adult-use groups were 4.5-fold (adjusted; 95%CI: 1.4–14.7; p = .01) and 4.7-fold (adjusted; 95%CI: 1.3–16.2; p = .02) more likely to use cannabis. Across all groups, smoking was the most common method of intake and over 49% of users reported using partially or entirely for adult-use purposes.

Conclusions: The increased use with legalization motivates further research on the impacts of cannabis as a therapeutic agent during pregnancy and supports the need for increased screening and patient counseling regarding the potential effects of cannabis use on fetal development.

Disclosure statement

Hance Clarke and Karim S. Ladha are co-principal investigators of an observational study on medical cannabis funded by Shoppers Drug Mart.

Additional information

Funding

Ms. Vachhani was supported by Kennan Research Summer Student Program Research Award from St. Michael’s Hospital (Toronto, Canada). Dr. Wijeysundera, Dr. Clarke, and Dr. Ladha are supported in part by a Merit Award from the Department of Anesthesiology and Pain Medicine at the University of Toronto.

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