Pregnancy-related emergency visits for cannabis and alcohol increased during the COVID-19 pandemic
During the COVID-19 pandemic, the odds of pregnancy-related emergency department visits involving cannabis increased 10% and alcohol by 16%, with Medicaid-insured and uninsured patients showing consistently elevated odds across substance types.
Quick Facts
What This Study Found
Pandemic period showed increased odds of ED visits involving alcohol (aOR=1.16, 95% CI: 1.05-1.27) and cannabis (aOR=1.10, 95% CI: 1.01-1.20). African American individuals had prepandemic higher odds of cannabis use. Disparities in cannabis use narrowed for Hispanic and Native American individuals relative to White individuals during the pandemic.
Key Numbers
Cannabis ED visits: 10% increase during pandemic (aOR=1.10). Alcohol: 16% increase (aOR=1.16). Medicaid and uninsured: consistently elevated odds for opioid, cannabis, and nicotine use. Cannabis disparities narrowed for Hispanic and Native American vs White.
How They Did This
Difference-in-differences analysis of 2019-2021 Nationwide Emergency Department Sample data examining ED visits among pregnant individuals with documented substance use. Disparities assessed by race/ethnicity and insurance status.
Why This Research Matters
The pandemic exacerbated substance use during pregnancy, a period when both mother and fetus are vulnerable. The finding that cannabis-related visits increased suggests pandemic stressors may have driven increased use among pregnant individuals.
The Bigger Picture
Societal disruptions appear to increase prenatal substance use, particularly among already-vulnerable populations. The narrowing of racial disparities in cannabis use during the pandemic suggests the stressor equally affected groups that previously had lower use rates.
What This Study Doesn't Tell Us
ED visits represent the most acute cases, not total prenatal substance use. Difference-in-differences cannot fully control for secular trends. Substance documentation in ED records may be inconsistent.
Questions This Raises
- ?Did the pandemic-related increase in prenatal cannabis use persist after COVID restrictions eased?
- ?Would proactive outreach during societal crises reduce prenatal substance use?
Trust & Context
- Key Stat:
- in pregnancy-related ED visits involving cannabis during the COVID-19 pandemic
- Evidence Grade:
- National ED database with difference-in-differences methodology provides strong epidemiological evidence, though limited to the most acute presentations.
- Study Age:
- 2025 publication with 2019-2021 data.
- Original Title:
- Socioeconomic Disparities in Perinatal Substance Use Emergency Department Visits Before and During COVID-19.
- Published In:
- Journal of women's health (2002), 34(12), 1548-1557 (2025)
- Authors:
- González-Alvarez, Ana Daniela, Kapukotuwa, Sidath, Hurst, Larry, Owusu-Ansah, Abena Gyawu, Guo, Ying, Vaderlaan, Jennifer, Shen, Jay J
- Database ID:
- RTHC-06561
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Why did prenatal substance use increase during the pandemic?
Multiple stressors converged: social isolation, economic hardship, disrupted healthcare access, increased mental health burden, and reduced availability of substance use treatment services. These disproportionately affected populations already vulnerable to substance use.
Which populations were most affected?
Medicaid-insured and uninsured individuals showed consistently elevated odds across substance types. African American individuals had higher prepandemic cannabis use rates. Interestingly, Hispanic and Native American cannabis use disparities narrowed during the pandemic, suggesting broader-based increases.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-06561APA
González-Alvarez, Ana Daniela; Kapukotuwa, Sidath; Hurst, Larry; Owusu-Ansah, Abena Gyawu; Guo, Ying; Vaderlaan, Jennifer; Shen, Jay J. (2025). Socioeconomic Disparities in Perinatal Substance Use Emergency Department Visits Before and During COVID-19.. Journal of women's health (2002), 34(12), 1548-1557. https://doi.org/10.1177/15409996251370887
MLA
González-Alvarez, Ana Daniela, et al. "Socioeconomic Disparities in Perinatal Substance Use Emergency Department Visits Before and During COVID-19.." Journal of women's health (2002), 2025. https://doi.org/10.1177/15409996251370887
RethinkTHC
RethinkTHC Research Database. "Socioeconomic Disparities in Perinatal Substance Use Emergen..." RTHC-06561. Retrieved from https://rethinkthc.com/research/gonzalez-alvarez-2025-socioeconomic-disparities-in-perinatal
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.