Brief Screening Tool Identified Risk Factors for Prenatal Cannabis Use
A brief psychosocial screener used at the first prenatal visit found that being unpartnered tripled the odds of prenatal cannabis use, while past-year substance use predicted use of all substances during pregnancy.
Quick Facts
What This Study Found
Among 1,842 pregnant patients screened with the PROMOTE instrument, 2.7% used cannabis prenatally. Being unpartnered was uniquely associated with prenatal cannabis use (AOR=3.37), while past-year tobacco and illegal drug use predicted all three substances (tobacco, cannabis, alcohol).
Key Numbers
10.2% (188) used at least one substance prenatally. Tobacco: 7.2%, cannabis: 2.7%, alcohol: 2.4%. Being unpartnered: AOR 3.37 for cannabis. Low education: AOR 2.74 for tobacco. Major life events: AOR 3.25 for alcohol.
How They Did This
Retrospective chart review of 1,842 patients who completed the PROMOTE psychosocial screening instrument at their first prenatal visit to New York State outpatient clinics from June 2019 to November 2020. Substance use was identified from medical records including clinical notes, self-report, and urine toxicology.
Why This Research Matters
Identifying prenatal substance use early allows for earlier intervention. This study shows that a brief, routine screening tool can flag specific psychosocial risk factors unique to each substance.
The Bigger Picture
Universal psychosocial screening at prenatal visits could improve identification of at-risk individuals. Different substances have different risk profiles, suggesting targeted rather than one-size-fits-all approaches.
What This Study Doesn't Tell Us
Single health system in New York. Retrospective design may miss unreported use. Small number of cannabis users (n=50) limits statistical power. Study period overlapped with COVID-19 pandemic.
Questions This Raises
- ?Would the PROMOTE screener perform similarly in other settings?
- ?How do these risk factors interact with each other?
Trust & Context
- Key Stat:
- 3.37x higher odds of prenatal cannabis use for unpartnered patients
- Evidence Grade:
- Moderate: structured screening data from a real clinical setting, but small cannabis user sample and single health system
- Study Age:
- Published in 2025 using 2019-2020 data
- Original Title:
- Using the PROMOTE Screener to Identify Psychosocial Risk Factors for Prenatal Substance Use.
- Published In:
- Journal of addiction medicine, 19(2), 216-222 (2025)
- Authors:
- Azeem, Ayesha, Lobel, Marci, Heiselman, Cassandra, Preis, Heidi
- Database ID:
- RTHC-05985
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
What is the PROMOTE screener?
It is an 18-item psychosocial screening tool used at the first prenatal visit to assess vulnerabilities like stress, unstable living conditions, and past substance use. It includes the NIDA Quick Screen for substance use.
Why was being unpartnered specifically linked to cannabis?
The study found this statistical association but did not determine the mechanism. It may reflect social support, stress, or other factors that overlap with partner status and cannabis use.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-05985APA
Azeem, Ayesha; Lobel, Marci; Heiselman, Cassandra; Preis, Heidi. (2025). Using the PROMOTE Screener to Identify Psychosocial Risk Factors for Prenatal Substance Use.. Journal of addiction medicine, 19(2), 216-222. https://doi.org/10.1097/ADM.0000000000001427
MLA
Azeem, Ayesha, et al. "Using the PROMOTE Screener to Identify Psychosocial Risk Factors for Prenatal Substance Use.." Journal of addiction medicine, 2025. https://doi.org/10.1097/ADM.0000000000001427
RethinkTHC
RethinkTHC Research Database. "Using the PROMOTE Screener to Identify Psychosocial Risk Fac..." RTHC-05985. Retrieved from https://rethinkthc.com/research/azeem-2025-using-the-promote-screener
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.