Among 15,429 postpartum women, latent class analysis identified seven substance use patterns including a distinct pre-pregnancy cannabis user class (5.5%) who largely stopped during pregnancy.
OB-GYNs, perinatal substance use researchers, and maternal health policymakers.
5.5% of postpartum women fell in a distinct pre-pregnancy cannabis user class who largely stopped during pregnancy
What the researchers found
Seven latent classes of maternal substance use were identified: minimal users (70.7%), pre-pregnancy cigarette users (10.5%), persistent cigarette users (6.8%), pre-pregnancy cannabis users (5.5%), broad polysubstance users (3.6%), opioid-only users (1.9%), and persistent cigarette/opioid co-users (1.0%). Groups differed significantly by age, income, race/ethnicity, and pre-pregnancy alcohol use.
Why it matters
Identifying distinct substance use patterns rather than treating all prenatal substance exposure as equivalent can help target interventions more effectively and understand different risk profiles for perinatal outcomes.
The numbers in context
15,429 participants representing 384,918 births. 51.3% aged 20-29. 73.3% non-Hispanic White. Seven classes: minimal (70.7%), pre-pregnancy cigarettes (10.5%), persistent cigarettes (6.8%), pre-pregnancy cannabis (5.5%), broad polysubstance (3.6%), opioid-only (1.9%), persistent cigarette+opioid (1.0%).
How the study worked
Analysis of 15,429 PRAMS postpartum survey participants (2016-2018) from seven U.S. states, representing 384,918 live singleton births. Latent class analysis identified patterns of substance use before and during pregnancy. State-level survey weights applied.
What this study cannot tell us
Self-reported substance use likely underestimates prevalence. Only seven states included, limiting national representativeness. Cannot determine substance quantities or frequency within classes. 73.3% non-Hispanic White limits racial/ethnic diversity.
How to read the evidence
Large representative sample with sophisticated latent class methodology, but self-report and limited state coverage reduce precision.
When this study was published
2025 publication with 2016-2018 PRAMS data.
The bigger picture
The pre-pregnancy cannabis user class (5.5%) is notable because these women largely stopped cannabis use during pregnancy, distinguishing them from persistent substance users. This suggests cannabis-using women may be responsive to pregnancy-motivated cessation.
Questions still open
- Do the perinatal outcomes differ across these seven substance use classes?
- What motivates pre-pregnancy cannabis users to stop during pregnancy while cigarette users persist?
Read the original research
Typologies of Maternal Substance Use in Pregnancy: Latent Classes and Sociodemographic Correlates in a U.S. Sample.
Journal of studies on alcohol and drugs, 86(5), 694-702
Citation
Jenkins, Marina C; Ehrenthal, Deborah B; Bautista, Leonelo E. (2025). Typologies of Maternal Substance Use in Pregnancy: Latent Classes and Sociodemographic Correlates in a U.S. Sample.. Journal of studies on alcohol and drugs, 86(5), 694-702. https://doi.org/10.15288/jsad.24-00210
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