1 in 6 Pregnancies in Michigan Involved Cannabis Use
A statewide population-based study found 16.8% of pregnant women in Michigan used cannabis, with depression, adverse childhood experiences, and lower education strongly associated with use.
Quick Facts
What This Study Found
Weighted prevalence of prenatal cannabis use was 16.8% combining self-report and urinalysis; self-report alone captured 12.3% while urinalysis caught 13.3%, indicating neither method alone captures the full picture.
Key Numbers
16.8% overall prevalence; 12.3% by self-report; 13.3% by urinalysis; depression aPRR=1.72; ACEs ≥3 aPRR=2.04; single status aPRR=2.08; some college vs. undergrad+ aPRR=3.76.
How They Did This
Prospective statewide pregnancy cohort (MARCH/ECHO) using three-stage stratified cluster sampling across Michigan's lower peninsula, with 1,092 participants providing self-reports and/or urine toxicology during pregnancy.
Why This Research Matters
One in six pregnancies involving cannabis is a public health figure that demands attention — and the finding that self-report underestimates use means the true number may be even higher.
The Bigger Picture
This is among the most methodologically rigorous estimates of prenatal cannabis use in the US, and the strong links to depression and childhood trauma suggest cannabis use in pregnancy is often self-medication for unmet mental health needs.
What This Study Doesn't Tell Us
Michigan-specific results may not generalize to all states; recruitment at prenatal clinics misses those without prenatal care; urine captures recent use but may miss intermittent users.
Questions This Raises
- ?How has prenatal cannabis prevalence changed since Michigan's recreational legalization in 2018?
- ?Would integrated mental health support during pregnancy reduce cannabis use?
Trust & Context
- Key Stat:
- Evidence Grade:
- Large population-based cohort with dual verification methods (self-report and urinalysis), complex survey design, and multivariate analysis from NIH ECHO program.
- Study Age:
- Published in 2026 with data from 2017-2023, capturing the transition period around recreational cannabis legalization.
- Original Title:
- Prevalence and characteristics of prenatal cannabis use in Michigan, USA: A statewide population-based pregnancy cohort.
- Published In:
- Addiction (Abingdon, England), 121(1), 126-137 (2026)
- Authors:
- Al-Sahab, Ban(2), Kerver, Jean M(3), Alshaarawy, Omayma(9), Bohnert, Kipling M, Elliott, Michael R, Qiu, Hongxiang, Jaber, Audriyana, Neelam, Harish, Paneth, Nigel
- Database ID:
- RTHC-08069
Evidence Hierarchy
Frequently Asked Questions
How common is cannabis use during pregnancy?
This Michigan study found about 1 in 6 pregnancies (16.8%) involved cannabis use when combining self-report and urine testing, making it one of the most commonly used substances during pregnancy.
Who is most likely to use cannabis during pregnancy?
Women who were single, had lower education, experienced depression symptoms, and had a history of adverse childhood experiences were significantly more likely to use cannabis while pregnant.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-08069APA
Al-Sahab, Ban; Kerver, Jean M; Alshaarawy, Omayma; Bohnert, Kipling M; Elliott, Michael R; Qiu, Hongxiang; Jaber, Audriyana; Neelam, Harish; Paneth, Nigel. (2026). Prevalence and characteristics of prenatal cannabis use in Michigan, USA: A statewide population-based pregnancy cohort.. Addiction (Abingdon, England), 121(1), 126-137. https://doi.org/10.1111/add.70188
MLA
Al-Sahab, Ban, et al. "Prevalence and characteristics of prenatal cannabis use in Michigan, USA: A statewide population-based pregnancy cohort.." Addiction (Abingdon, 2026. https://doi.org/10.1111/add.70188
RethinkTHC
RethinkTHC Research Database. "Prevalence and characteristics of prenatal cannabis use in M..." RTHC-08069. Retrieved from https://rethinkthc.com/research/al-sahab-2026-prevalence-and-characteristics-of
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.