Prenatal Cannabis Exposure Alone Didn't Predict Child Maltreatment After Policy Changed

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.

Ryan, Joseph P et al.·Child abuse & neglect·2025·Moderate EvidenceRetrospective Cohort
RTHC-07538Retrospective CohortModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
N=35,437

What This Study 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.

Key Numbers

35,437 births. Black and multiracial newborns significantly more likely to be tested. Post-policy: THC-only positive had no higher maltreatment rate.

How They Did This

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.

Why This Research 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 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.

What This Study Doesn't Tell Us

Single-center. Michigan-specific policy. Cannot assess heavy/chronic use separately. Meconium captures third-trimester exposure only.

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
THC-only exposure did not predict maltreatment after policy reform
Evidence Grade:
Moderate: large cohort with natural policy experiment, but single-center.
Study Age:
Published in 2025, with data spanning 2013-2023.
Original Title:
Prenatal cannabis exposure and the risk of subsequent maltreatment.
Published In:
Child abuse & neglect, 160, 107175 (2025)
Database ID:
RTHC-07538

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Does prenatal cannabis use lead to child maltreatment?

After removing the automatic link between prenatal THC and abuse substantiation, newborns testing positive for THC only were no more likely to be maltreated.

Are drug tests at birth applied equally across races?

No. This study found Black and multiracial newborns were significantly more likely to be drug-tested at birth.

Read More on RethinkTHC

Cite This Study

RTHC-07538·https://rethinkthc.com/research/RTHC-07538

APA

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

MLA

Ryan, Joseph P, et al. "Prenatal cannabis exposure and the risk of subsequent maltreatment.." Child abuse & neglect, 2025. https://doi.org/10.1016/j.chiabu.2024.107175

RethinkTHC

RethinkTHC Research Database. "Prenatal cannabis exposure and the risk of subsequent maltre..." RTHC-07538. Retrieved from https://rethinkthc.com/research/ryan-2025-prenatal-cannabis-exposure-and

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.