Nearly 7% of Pregnant Women Used Cannabis, with Highest Rates in the First Trimester

Among 94,225 women of reproductive age (including 2,051 pregnant), cannabis use prevalence was 12.6% for nonpregnant and 6.8% for pregnant women. First-trimester use was highest at 10.1%, peaking at 14.2% in 2022. Smoking was the predominant method (65.4% of pregnant users). Past 30-day alcohol use (aOR=7.51), illicit drug use (aOR=4.70), tobacco use (aOR=3.04), and past-year major depressive episode (aOR=2.52) were all strongly associated with cannabis use during pregnancy.

Secondary analysis of 2021-2023 National Survey on Drug Use and Health data. Assessed cannabis use prevalence, methods (smoking, vaping, edibles), and correlates among pregnant and nonpregnant women aged 12-44. Multivariable logistic regression adjusted for survey design.

This is the most current national estimate of cannabis use in pregnancy, revealing that first-trimester exposure, when fetal organ development is most vulnerable, occurs at rates above 10%. The strong association with depression and other substance use suggests opportunities for integrated screening.

Cannabis use among nonpregnant women of reproductive age is increasing, which means more women may enter pregnancy as active users. The stability of pregnant women's use rates, despite rising use overall, may reflect awareness of pregnancy risks, but first-trimester rates remain high.

Self-report data likely underestimates actual use. Cross-sectional design within each survey year. Cannot assess outcomes for mothers or infants. Survey excludes institutionalized populations. Cannabis use in early pregnancy may predate pregnancy awareness.