The number of pregnant women using cannabis in the United States has more than tripled over the last two decades. Researchers are now calling for more studies to better understand this trend and to inform intervention strategies.
A study conducted by researchers at Columbia University Mailman School of Public Health and the Columbia University Irving Medical Center reveals that past-month cannabis use among pregnant women rose significantly from 1.5 percent in 2002 to 5.4 percent in 2020. This increase was tracked over an 18-year period, highlighting a growing public health concern.
Medical guidelines currently recommend that pregnant women abstain from cannabis due to its association with adverse maternal and neonatal outcomes. There are also concerns regarding the long-term effects of cannabis on mental health.
To explore cannabis use disorder (CUD) diagnoses during pregnancy, researchers analyzed data from the Merative™ Marketscan® Commercial Claims and Encounters Database. This database included pregnant women aged 12 to 55 who had continuous insurance enrollment between 2015 and 2020. They identified CUD diagnoses using the International Classification of Diseases codes.
The findings, published in the American Journal of Preventive Medicine, indicate that from 2015 to 2020, 893,430 pregnant women were identified, resulting in a total of 1,058,448 pregnancies. The cumulative prevalence of CUD diagnosis was found to be 0.26%, with yearly prevalence ranging from 0.22% in 2015 to 0.27% in 2018 and 2019.
Priscila Gonçalves, PhD, an assistant professor in the Department of Psychiatry at Columbia University Irving Medical Center and the first author of the study, noted that previous research focused on limited geographic samples. This study aimed to assess the prevalence of CUD diagnoses among a large group of commercially insured women over five years.
In 2020, cannabis for medical use was legal in 34 states and Washington D.C. This raises the possibility that some women may be self-medicating during pregnancy due to cannabis’s anti-nausea properties. However, it is also likely that many pregnant women meet the criteria for CUD.
Clinicians who frequently interact with pregnant women have the potential to address cannabis use and CUD. However, they might lack the necessary structural support to implement effective interventions. Gonçalves highlighted that some women may also fear legal repercussions for disclosing substance use, which could lead to underreported CUD diagnoses and hinder appropriate medical interventions.
Silvia Martins, MD, PhD, a professor of Epidemiology at Columbia Mailman School and the senior author of the study, emphasized that the results underscore the importance of understanding the factors leading to CUD among pregnant women. This includes examining the severity of CUD and the elements that contribute to diagnosis and treatment.
Martins concluded that the study clearly indicates a need for additional research to better inform prevention and intervention efforts related to cannabis use among pregnant women.
