Prenatal cannabis use in California nearly doubled amid legalization from 2012 to 2022
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Key takeaways:
- Prenatal cannabis use increased for all racial, ethnic and age groups from 2012 to 2022.
- The increase in cannabis use was consistent whether assessed by self-report or urine toxicology testing.
From 2012 to 2022, prenatal cannabis use increased across race, ethnicity and age groups for pregnant women in Northern California, where cannabis was legalized in 2016 and legal cannabis sales began in 2018, according to a research letter.
“Recent increases in prenatal cannabis use across different races, ethnicities and age groups highlight the importance of educating all pregnant individuals about the potential risks involved,” Kelly C. Young-Wolff, PhD, MPH, research scientist at Kaiser Permanente Northern California, told Healio. “Although we observed a slower increase in the prevalence of prenatal cannabis use among groups with the highest initial prevalence, significant disparities have remained over time. It is crucial that we offer support through nonjudgmental education and advice to quit cannabis use during pregnancy, and culturally sensitive interventions tailored to the individual needs of each pregnant patient.”
Young-Wolff and colleagues conducted a population-based, cross-sectional study, published in Obstetrics & Gynecology, utilizing electronic health record data from 76,961 pregnancies from women in California. Researchers evaluated changes in self-reported prenatal cannabis use and urine toxicology tests during standard prenatal care visits between 2012 (n = 33,546) and 2022 (n = 43,415). Researchers also assessed whether trends differed by race, ethnicity or age.
Prenatal cannabis use prevalence increased from 5.5% in 2012 to 9% in 2022, for an adjusted prevalence ratio (aPR) of 1.82 (95% CI, 1.72-1.92). Researchers observed similar prenatal cannabis prevalence via toxicology test (aPR = 1.7; 95% CI, 1.6-1.81) and self-report (aPR = 2.12; 95% CI, 1.95-2.3).
“It is noteworthy that the increase in prenatal cannabis use was consistent across both self-report and urine toxicology testing,” Young-Wolff told Healio. “This parallel rise in both measures suggests a genuine increase in usage, rather than simply a greater willingness to disclose prenatal cannabis use over time.”
Prenatal cannabis use prevalence increased for all racial, ethnic and age groups from 2012 to 2022. Black women had the highest prevalence of prenatal cannabis use, rising from 20.2% in 2012 to 29.3% in 2022. Asian women had the lowest prevalence, rising from 0.7% in 2012 and 2.4% in 2022.
Adolescents and young adults aged 13 to 24 years had the highest prevalence of prenatal cannabis use, rising from 15.5% in 2012 to 22.8% in 2022.
According to the researchers, increases in prenatal cannabis use highlight the need to educate all pregnant women of potential risks associated with prenatal cannabis use and refer women to “nonjudgmental, culturally sensitive interventions” as needed.
“Research is needed to understand how state and local cannabis policies impact prenatal cannabis use,” Young-Wolff told Healio. “There is also an urgent need to investigate how different modes of cannabis use — such as smoking, vaping or consuming edibles — and varying strengths of cannabis products impact both maternal and fetal health outcomes. Each method of consumption may have distinct short-term and long-term health implications, making it crucial to understand these differences.”
For more information:
Kelly C. Young-Wolff, PhD, MPH, can be reached at kelly.c.young-wolff@kp.org.