Prenatal Cannabis Use Linked to More Missed Pediatric Check-Ups in First Three Years
Among 168,589 pregnancies, children of mothers who used cannabis prenatally were 43% more likely to miss their 12-month well-child visit and 36% were missing two or more visits by age 3, compared to 23% of children from non-using mothers.
Quick Facts
What This Study Found
Maternal prenatal cannabis use was associated with more missed well-child visits at every time period from birth through 36 months. The strongest association was at the 12-month visit (aRR: 1.43, 95% CI: 1.32-1.54). By 36 months, 35.8% of children born to cannabis-using mothers had missed two or more visits compared to 23.0% of children from non-users.
Key Numbers
168,589 pregnancies; 3.4% screened positive for prenatal cannabis use; 12-month visit aRR: 1.43; 3-year visit aRR: 1.15; 35.8% vs 23.0% missed 2+ visits by 36 months
How They Did This
Longitudinal cohort study of 168,589 pregnancies in Kaiser Permanente Northern California (2011-2018). Prenatal cannabis use defined by self-report or positive urine toxicology. Well-child visits tracked across seven time periods from birth to 36 months. Modified Poisson regression adjusted for covariates.
Why This Research Matters
Well-child visits are critical for catching developmental problems early, especially in children with potential prenatal exposures. Missing these visits means missed opportunities to identify and address any cannabis-related developmental effects.
The Bigger Picture
This creates a double vulnerability: children potentially affected by prenatal cannabis exposure are also less likely to receive the preventive care that could identify and address any resulting developmental issues. Addressing barriers to well-child visit attendance for this population should be a priority.
What This Study Doesn't Tell Us
Cannot determine why mothers who used cannabis missed more visits. Potential confounders include socioeconomic factors, other substance use, and mental health conditions. Cannabis screening may underidentify users. Single health system limits generalizability.
Questions This Raises
- ?What barriers to well-child visit attendance do cannabis-using mothers face?
- ?Would targeted outreach improve attendance?
- ?Is the missed-visit pattern driven by the same factors that led to prenatal cannabis use?
Trust & Context
- Key Stat:
- 168,589 pregnancies analyzed
- Evidence Grade:
- Large population-based cohort with objective cannabis screening, but observational design with potential unmeasured confounding
- Study Age:
- 2023 study
- Original Title:
- Association between maternal prenatal cannabis use and missed child preventive care visits in an integrated health care delivery system in Northern California.
- Published In:
- Preventive medicine, 175, 107716 (2023)
- Authors:
- Avalos, Lyndsay A(13), Oberman, Nina(5), Alexeeff, Stacey E(19), Croen, Lisa A, Adams, Sara R, Davignon, Meghan, Young-Wolff, Kelly C
- Database ID:
- RTHC-04383
Evidence Hierarchy
Follows a group of people over time to track how outcomes develop.
What do these levels mean? →Frequently Asked Questions
Does prenatal cannabis use affect pediatric care attendance?
Yes. Children of mothers who used cannabis during pregnancy were significantly more likely to miss well-child visits at every check-up through age 3, with the strongest association at the 12-month visit.
Why do cannabis-using mothers miss more visits?
This study did not determine why. Possible factors include socioeconomic challenges, fear of judgment, stigma, or overlapping risk factors like mental health conditions that affect both cannabis use and healthcare engagement.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-04383APA
Avalos, Lyndsay A; Oberman, Nina; Alexeeff, Stacey E; Croen, Lisa A; Adams, Sara R; Davignon, Meghan; Young-Wolff, Kelly C. (2023). Association between maternal prenatal cannabis use and missed child preventive care visits in an integrated health care delivery system in Northern California.. Preventive medicine, 175, 107716. https://doi.org/10.1016/j.ypmed.2023.107716
MLA
Avalos, Lyndsay A, et al. "Association between maternal prenatal cannabis use and missed child preventive care visits in an integrated health care delivery system in Northern California.." Preventive medicine, 2023. https://doi.org/10.1016/j.ypmed.2023.107716
RethinkTHC
RethinkTHC Research Database. "Association between maternal prenatal cannabis use and misse..." RTHC-04383. Retrieved from https://rethinkthc.com/research/avalos-2023-association-between-maternal-prenatal
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.