After California legalized recreational marijuana, Black and White pregnant individuals had the highest cannabis detection rates (12-13%), with significant racial disparities in both tobacco and cannabis exposure.
Obstetricians, maternal health researchers, and health equity advocates.
13% cannabis detectionin Black pregnant individuals by serum biomarker, highest among six racial/ethnic groups studied
What the researchers found
Cannabis was detected in 5% of Hispanic to 13% of Black pregnant individuals. Cannabis exposure was higher among tobacco users. Black subjects uniquely showed higher cannabis use in older, higher-SES subgroups.
Why it matters
Identifying which pregnant populations have the highest substance exposure allows targeted interventions to reduce known prenatal risks.
The numbers in context
925 prenatal screening participants (2018-2020). Tobacco: Black 16%, Native American 10%, White 8%, Hispanic/Asian/Vietnamese ≤2%. Cannabis: Black 13%, White 12%, Hispanic 5%. Cannabis higher among tobacco users.
How the study worked
Cross-sectional analysis of banked prenatal serum samples from southern/central California, measuring cotinine (tobacco) and OH-THC (cannabis) by laboratory analysis across six racial/ethnic groups.
Who was studied
925 prenatal screening program participants from six racial/ethnic groups in southern/central California (2018-2020).
What this study cannot tell us
Serum biomarkers capture recent but not chronic exposure. Relatively small subgroup sizes. Southern/central California may not represent all regions. 2018-2020 may include early legalization effects.
How to read the evidence
Objective biomarker measurement eliminates self-report bias; cross-sectional design limits temporal inference.
When this study was published
Data from 2018-2020, the first three years after California recreational legalization.
The bigger picture
This objective biomarker-based study confirms racial disparities in prenatal substance exposure that self-report studies may underestimate, and reveals unique patterns within racial groups that defy simple stereotypes.
Replication
California-specific; other state comparisons would be valuable.
Funding
Not specified in abstract
Conflicts of interest
Not specified in abstract
Questions still open
- Why do older, higher-SES Black women have more cannabis exposure?
- Would targeted prenatal screening reduce disparities in exposure?
Read the original research
Prenatal Exposure to Tobacco and Cannabis in Six Race/Ethnicity Groups during the First Three Years after Legalization of Cannabis for Recreational Use in California.
International journal of environmental research and public health, 21(1)
Citation
Kharrazi, Martin; Berger, Kimberly; Pearl, Michelle; Li, Ying; DeGuzman, Josephine; Behniwal, Paramjit; Morse, Allison; Moskalenko, Ilya; Williams, Rebecca J; She, Jianwen. (2023). Prenatal Exposure to Tobacco and Cannabis in Six Race/Ethnicity Groups during the First Three Years after Legalization of Cannabis for Recreational Use in California.. International journal of environmental research and public health, 21(1). https://doi.org/10.3390/ijerph21010011