A New Study Is Tracking How Vaping and Cannabis Affect Pregnancy in West Virginia

Researchers enrolled 417 pregnant women in their first trimester to prospectively track e-cigarette and cannabis exposure alongside maternal-infant outcomes — the first study of its kind in Appalachia.

Gibbs, Bethany Barone et al.·American journal of epidemiology·2026·Preliminary EvidenceProspective Cohort·1 min read
RTHC-08276Prospective CohortPreliminary Evidence2026RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Prospective Cohort
Evidence
Preliminary Evidence
Sample
N=417
Participants
N=417 pregnant women in their first trimester, recruited from West Virginia University Medicine obstetric clinics.

What This Study Found

The Mountain Mama & Baby Study established a prospective cohort of pregnant women in West Virginia, enrolling participants during their first-trimester telehealth visits with nurse navigators. Of 920 eligible women, 417 (45.3%) enrolled — more than double the 20% benchmark the researchers set.

The enrolled participants closely matched non-enrolled women across most sociodemographic characteristics including age, race/ethnicity, and marital status, suggesting the sample is representative of the broader obstetric population in the region.

The study's design addresses key limitations of prior prenatal exposure research: it captures exposure data prospectively in the first trimester (rather than relying on retrospective recall), collects biospecimens for objective exposure verification, and follows participants through delivery to link exposure to specific maternal-infant outcomes. The cohort will establish first and third trimester exposure rates for both e-cigarettes and cannabis in a population with high rates of substance use.

Key Numbers

920 eligible women, 417 enrolled (45.3%, 95% CI: 42.1–48.6%). Benchmark enrollment rate was 20%. Enrolled and non-enrolled women were similar across most sociodemographic characteristics.

How They Did This

Prospective cohort study enrolling pregnant women during first-trimester telehealth visits at West Virginia University Medicine obstetric clinics. Recruitment via nurse navigators. Self-reported substance use data collected at enrollment with planned follow-up through delivery. Feasibility assessed by enrollment rate and representativeness compared to non-enrolled eligible patients.

Why This Research Matters

Most research on prenatal cannabis exposure relies on retrospective self-report or birth registry data, both of which underestimate actual use. This prospective design — capturing exposure early in the first trimester before many women even know they're pregnant in other studies — could produce more accurate prevalence estimates and stronger links to outcomes. West Virginia's high substance use rates make it a particularly important population to study.

The Bigger Picture

This cohort study joins a growing body of prospective prenatal cannabis research. While animal studies (RTHC-00236, RTHC-00239) and large observational datasets like the ABCD Study (RTHC-00241) have documented associations between prenatal cannabis exposure and offspring outcomes, prospective cohorts with biospecimen collection can bridge the gap between those approaches — providing both the rigor of verified exposure data and the relevance of human outcomes.

What This Study Doesn't Tell Us

Single-center study in West Virginia, which may not generalize to other populations. The 45.3% enrollment rate, while exceeding benchmarks, means over half of eligible women did not participate. Self-reported substance use at enrollment may still underestimate actual use despite the prospective design. Outcomes data are not yet reported — this paper describes the study design and recruitment feasibility only.

Questions This Raises

  • ?What are the first-trimester e-cigarette and cannabis use rates in this Appalachian population?
  • ?Do objective biospecimen measures confirm or diverge from self-reported use?
  • ?Will this cohort have sufficient statistical power to detect associations between early cannabis exposure and specific birth outcomes?

Trust & Context

Key Stat:
Evidence Grade:
Prospective cohort design paper — describes methodology and recruitment feasibility, with exposure and outcome data still forthcoming.
Study Age:
Published in 2026, describing an actively enrolling cohort. Exposure and outcome results are expected in future publications.
Original Title:
Building the Mountain Mama and Baby Cohort: Study Design, Protocol, and Early Prenatal Clinic-based Recruitment Outcomes.
Published In:
American journal of epidemiology (2026)The American Journal of Epidemiology is a well-respected journal focusing on public health and epidemiological research.
Database ID:
RTHC-08276

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Enrolls participants and follows them forward in time.

What do these levels mean? →

Read More on RethinkTHC

Cite This Study

RTHC-08276·https://rethinkthc.com/research/RTHC-08276

APA

Gibbs, Bethany Barone; Chmelik, Kathryn; Marshall, Elly M; Henggeler, Waylon K; Olfert, I Mark; Rowan, Shon; Lilly, Christa; Hodder, Sally L; Umer, Amna. (2026). Building the Mountain Mama and Baby Cohort: Study Design, Protocol, and Early Prenatal Clinic-based Recruitment Outcomes.. American journal of epidemiology. https://doi.org/10.1093/aje/kwag030

MLA

Gibbs, Bethany Barone, et al. "Building the Mountain Mama and Baby Cohort: Study Design, Protocol, and Early Prenatal Clinic-based Recruitment Outcomes.." American journal of epidemiology, 2026. https://doi.org/10.1093/aje/kwag030

RethinkTHC

RethinkTHC Research Database. "Building the Mountain Mama and Baby Cohort: Study Design, Pr..." RTHC-08276. Retrieved from https://rethinkthc.com/research/gibbs-2026-building-the-mountain-mama

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.