After a 2018 policy change stopped automatically substantiating prenatal THC exposure as physical abuse, newborns who tested positive for THC only were no more likely to be maltreated.
Parents, child welfare professionals, and anyone interested in cannabis policy's intersection with family law and racial equity.
THC-only exposure did not predict maltreatment after policy reform
What the researchers found
Among 35,437 births, Black and multiracial newborns were significantly more likely to be drug-tested. After the policy change, newborns testing positive for THC only were no more likely to experience subsequent maltreatment compared to those testing negative or not tested.
Why it matters
Policies equating prenatal cannabis exposure with child abuse can separate families, disproportionately affecting Black and multiracial families. This study provides evidence that prenatal THC alone does not predict maltreatment.
The numbers in context
35,437 births. Black and multiracial newborns significantly more likely to be tested. Post-policy: THC-only positive had no higher maltreatment rate.
How the study worked
Retrospective cohort linking University of Michigan birth data (n=35,437) with Michigan maltreatment data. Compared outcomes before and after 2018 policy change. Regression models adjusted for demographics.
What this study cannot tell us
Single-center. Michigan-specific policy. Cannot assess heavy/chronic use separately. Meconium captures third-trimester exposure only.
How to read the evidence
Moderate: large cohort with natural policy experiment, but single-center.
When this study was published
Published in 2025, with data spanning 2013-2023.
The bigger picture
As cannabis legalization spreads, many child welfare systems still treat any prenatal exposure as grounds for investigation. This study strengthens the case for policy reform and reveals racial bias in testing practices.
Questions still open
- Should CPS investigations for prenatal cannabis end nationwide?
- What role does racial bias play in newborn testing?
- How should prenatal cannabis use be addressed post-legalization?
Common questions
Does prenatal cannabis use lead to child maltreatment?
Are drug tests at birth applied equally across races?
Read the original research
Prenatal cannabis exposure and the risk of subsequent maltreatment.
Child abuse & neglect, 160, 107175
Citation
Ryan, Joseph P; Oshman, Lauren; Frank, Christopher J; Perron, Brian; Victor, Bryan; Sankaran, Vivek. (2025). Prenatal cannabis exposure and the risk of subsequent maltreatment.. Child abuse & neglect, 160, 107175. https://doi.org/10.1016/j.chiabu.2024.107175
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