Most pregnant people who kept using cannabis said their reasons shifted to symptom control

Of 105 pregnant respondents who screened positive for cannabis, 40 (38%) reported complete abstinence after pregnancy recognition while 65 (62%) continued use. Those who considered their use medical or mixed were four times as likely to continue (OR 4.0, 95% CI 1.3-12.8). Continued users were significantly more likely to discuss use with their obstetrician (89.2% vs 50%, P<0.001).

Cross-sectional survey of 105 pregnant patients at one prenatal practice in Baltimore, MD, who either self-reported cannabis use or tested positive on urine toxicology. Anonymous survey with multiple choice questions on frequency and reasons for use before and after pregnancy recognition.

Understanding why pregnant people continue cannabis use can inform more effective clinical conversations. The finding that continued users were more likely to disclose to their providers suggests openness to clinical guidance.

The shift from recreational to symptom-control motivations after pregnancy recognition suggests that providing safe, effective alternatives for symptoms like nausea could be a key strategy for reducing prenatal cannabis exposure.

Single prenatal practice in Baltimore limits generalizability. Self-reported data on timing and reasons for use. Cross-sectional design cannot capture changes over pregnancy. Cannabis use may be underreported despite anonymous survey.