A systematic review found polysubstance use during pregnancy is understudied, with wide-ranging prevalence estimates and cannabis frequently appearing as a co-used substance alongside tobacco, alcohol, or opioids.
Prenatal care providers, maternal health researchers, and substance use screening program designers.
Cannabis frequently appeared in prenatal polysubstance use combinations
What the researchers found
Polysubstance use during pregnancy involved diverse combinations, with cannabis commonly appearing alongside other substances. Prevalence estimates varied widely depending on screening method and population studied.
Why it matters
Most prenatal substance use research focuses on single substances, but real-world use often involves combinations. Understanding polysubstance patterns is essential for accurate risk assessment and targeted interventions.
The numbers in context
Literature from 2009-2020 reviewed. Cannabis was a common component of prenatal polysubstance use patterns alongside tobacco, alcohol, opioids, and stimulants.
How the study worked
Systematic review following PRISMA guidelines. Searched four databases for articles published January 2009 to June 2020 reporting prenatal exposure to two or more substances in the US.
What this study cannot tell us
Heterogeneous study designs and exposure definitions across included studies. Prevalence estimates are highly sensitive to screening methods used. Many studies relied on self-report. Publication date cutoff (2020) may miss recent trends.
How to read the evidence
Systematic review of heterogeneous studies. Useful for mapping the landscape but limited by inconsistent methods across included studies.
When this study was published
Published 2023. Literature through June 2020.
The bigger picture
Isolating the effects of cannabis in pregnancy is nearly impossible when polysubstance use is common. Until research accounts for substance combinations rather than single exposures, risk estimates for individual substances remain uncertain.
Questions still open
- How should prenatal screening protocols address polysubstance use rather than single substances? Do specific substance combinations carry higher risk than individual exposures?
Common questions
How common is using multiple substances during pregnancy?
Why does polysubstance use matter for pregnancy research?
Read the original research
Systematic Review: Polysubstance Prevalence Estimates Reported during Pregnancy, US, 2009-2020.
Maternal and child health journal, 27(3), 426-458
Citation
Tran, Emmy L; England, Lucinda J; Park, Youngjoo; Denny, Clark H; Kim, Shin Y. (2023). Systematic Review: Polysubstance Prevalence Estimates Reported during Pregnancy, US, 2009-2020.. Maternal and child health journal, 27(3), 426-458. https://doi.org/10.1007/s10995-023-03592-w
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