National survey data from 2021-2023 found 6.8% of pregnant women used cannabis, with first-trimester use highest at 10.1% and peaking at 14.2% in 2022.
OB-GYN providers, prenatal care teams, public health epidemiologists, maternal health researchers
What the researchers found
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.
Why it matters
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.
The numbers in context
94,225 women; 6.8% of pregnant women used cannabis; first-trimester use 10.1%, peaking at 14.2% in 2022; smoking: 65.4% of pregnant users; depression aOR=2.52; alcohol use aOR=7.51; nonpregnant cannabis use increased over the period
How the study worked
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.
What this study cannot tell us
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.
How to read the evidence
Strong: national probability sample across three survey years with large sample size and adjusted analyses.
When this study was published
2025 publication using 2021-2023 NSDUH data
The bigger picture
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.
Questions still open
- Is the high first-trimester rate driven by women who do not yet know they are pregnant?
- Would universal screening with brief intervention at first prenatal visit reduce ongoing use?
Read the original research
Cannabis Use Among Pregnant and Nonpregnant Women of Childbearing Age: Findings From the 2021-2023 National Survey of Drug Use and Health.
American journal of preventive medicine, 69(4), 107967
Citation
Grigsby, Timothy J; Assoumou, Bertille; Koning, Stephanie M; Howard, Jeffrey T; Howard, Krista. (2025). Cannabis Use Among Pregnant and Nonpregnant Women of Childbearing Age: Findings From the 2021-2023 National Survey of Drug Use and Health.. American journal of preventive medicine, 69(4), 107967. https://doi.org/10.1016/j.amepre.2025.107967
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