Analysis of nearly 2,000 pregnant participants in the NSDUH found 7% reported current cannabis use, with serious psychological distress (6.25x), alcohol use (7.24x), and e-cigarette use (4.92x) being the strongest correlates.
Obstetricians, pregnant individuals, prenatal health educators
Serious psychological distress increased odds of prenatal cannabis use 6.25x
What the researchers found
Nearly 7% of pregnant participants reported current (past 30-day) cannabis use. Among current users, 31% reported any doctor-recommended use and 52% bought from a dispensary. The strongest correlates of current use versus never use were: alcohol use (RRR = 7.24), serious psychological distress (RRR = 6.25), e-cigarette use (RRR = 4.92), higher education (RRR = 2.97), being unmarried (RRR = 2.54), cigarette use (RRR = 2.57), and younger age 18-25 (RRR = 2.08). Perceiving risk of weekly cannabis use dramatically reduced odds of current use (RRR = 0.07).
Why it matters
Cannabis use during pregnancy is associated with potential risks to fetal development. Understanding who uses and why is essential for developing targeted interventions, especially given that nearly a third of users report doctor-recommended use.
The numbers in context
1,992 pregnant participants; ~7% current use; 31% of users reported doctor-recommended use; 52% bought from dispensary; serious psychological distress: RRR = 6.25 (95% CI: 2.46-15.85); alcohol: RRR = 7.24 (95% CI: 1.52-34.49); e-cigarette: RRR = 4.92 (95% CI: 1.71-14.10); perceived risk: RRR = 0.07 (95% CI: 0.03-0.14)
How the study worked
Pooled cross-sectional analysis of 1,992 pregnant participants from NSDUH 2021-2023. Multinomial regression comparing correlates of current, recent, former, and never cannabis use, adjusting for sociodemographic and clinical variables.
What this study cannot tell us
Cross-sectional design cannot determine causality. NSDUH uses self-reported data which may undercount use during pregnancy. Cannot distinguish first, second, or third trimester use. Wide confidence intervals for some estimates.
How to read the evidence
Moderate: nationally representative survey with appropriate regression methods, but cross-sectional design and self-reported data, especially for a stigmatized behavior during pregnancy.
When this study was published
2026 publication analyzing NSDUH data from 2021-2023.
The bigger picture
The finding that risk perception is the strongest protective factor (93% reduced odds) suggests that public health messaging about cannabis and pregnancy risks could be effective. The high rate of psychological distress among users points to mental health as a key driver.
Questions still open
- Are clinicians recommending cannabis during pregnancy, or are women interpreting pre-pregnancy recommendations as continuing? Would addressing psychological distress reduce cannabis use in pregnancy? Does risk perception messaging reach the populations most likely to use?
Common questions
How common is cannabis use during pregnancy in the U.S.?
What predicts cannabis use during pregnancy?
Read the original research
Cannabis use in pregnancy: Key findings from 2021-2023 National Survey on Drug Use and Health data.
Addictive behaviors, 176, 108621
Citation
Wysota, Christina N; Sherman, Scott E; Abroms, Lorien C; Ghassabian, Akhgar; Hernandez, Sasha; Young-Wolff, Kelly C; Rogers, Erin S. (2026). Cannabis use in pregnancy: Key findings from 2021-2023 National Survey on Drug Use and Health data.. Addictive behaviors, 176, 108621. https://doi.org/10.1016/j.addbeh.2026.108621
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