Cannabis-involved pregnancy hospitalizations more than doubled in Colorado after legalization

Cannabis-involved pregnancy hospitalizations in Colorado increased from 429 to 1,210 (13.2 to 55.7 per 10,000 live births) between 2011 and 2018, with recreational dispensary access associated with the increase.

Wang, George Sam et al.·Preventive medicine·2022·Moderate EvidenceRetrospective Cohort
RTHC-04290Retrospective CohortModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Cannabis-involved pregnancy hospitalizations increased more than two-fold from 2011-2018. Increasing recreational dispensaries were associated with increases in hospitalizations (IRR 1.02). Counties with no prior medical cannabis exposure had greater increases than counties already exposed.

Key Numbers

Hospitalizations increased from 429 to 1,210. Per 10,000 live births: 13.2 to 55.7. Mean per county: 1.7 to 4.7. Recreational dispensary association: IRR 1.02. Previously unexposed counties had greater increases.

How They Did This

Retrospective cohort study of pregnancy-related hospitalizations co-coded with cannabis diagnoses in Colorado (2011-2018). Poisson regression assessed association between county-level recreational dispensary density and hospitalization rates, controlling for baseline medical dispensary exposure.

Why This Research Matters

The sharp increase in cannabis-involved pregnancy hospitalizations after legalization raises important public health questions about how legalization affects cannabis use during pregnancy.

The Bigger Picture

This is one of the first studies to directly link dispensary access to cannabis-involved pregnancy hospitalizations, providing data for the ongoing debate about legalization and maternal health.

What This Study Doesn't Tell Us

Administrative data may overcount if cannabis screening became more routine. Cannot distinguish between cannabis causing the hospitalization versus incidental detection. The IRR of 1.02, while significant, is small per dispensary.

Questions This Raises

  • ?Is the increase due to more cannabis use during pregnancy, more screening/detection, or both?
  • ?Are pregnancy outcomes worse in cannabis-involved hospitalizations?
  • ?Would educational interventions at dispensaries reduce use during pregnancy?

Trust & Context

Key Stat:
Hospitalizations increased from 13.2 to 55.7 per 10,000 live births
Evidence Grade:
Moderate: population-level administrative data with natural experiment design, but potential confounding from increased screening.
Study Age:
Published in 2022.
Original Title:
Cannabis legalization and cannabis-involved pregnancy hospitalizations in Colorado.
Published In:
Preventive medicine, 156, 106993 (2022)
Database ID:
RTHC-04290

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

Did cannabis use during pregnancy really increase that much?

The data show a more than two-fold increase in cannabis-involved pregnancy hospitalizations, but some of this increase could reflect more routine cannabis screening rather than more actual use.

Did counties without previous dispensaries see bigger increases?

Yes. Counties with no prior medical cannabis dispensary exposure had greater increases than counties that already had medical dispensaries, suggesting the newly available recreational market influenced use among pregnant individuals.

Does this mean cannabis harms pregnancies?

This study measured hospitalizations with a cannabis diagnosis code, not pregnancy outcomes. Whether the cannabis involvement caused harm requires separate investigation.

Read More on RethinkTHC

Cite This Study

RTHC-04290·https://rethinkthc.com/research/RTHC-04290

APA

Wang, George Sam; Buttorff, Christine; Wilks, Asa; Schwam, Daniel; Metz, Torri D; Tung, Gregory; Pacula, Rosalie Liccardo. (2022). Cannabis legalization and cannabis-involved pregnancy hospitalizations in Colorado.. Preventive medicine, 156, 106993. https://doi.org/10.1016/j.ypmed.2022.106993

MLA

Wang, George Sam, et al. "Cannabis legalization and cannabis-involved pregnancy hospitalizations in Colorado.." Preventive medicine, 2022. https://doi.org/10.1016/j.ypmed.2022.106993

RethinkTHC

RethinkTHC Research Database. "Cannabis legalization and cannabis-involved pregnancy hospit..." RTHC-04290. Retrieved from https://rethinkthc.com/research/wang-2022-cannabis-legalization-and-cannabisinvolved

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.