About 7% of pregnant people in the U.S. currently use cannabis, with psychological distress increasing odds more than sixfold

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.

Wysota, Christina N et al.·Addictive behaviors·2026·Moderate EvidenceCross-Sectional
RTHC-08722Cross SectionalModerate Evidence2026RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
Not reported

What This Study 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).

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
Serious psychological distress increased odds of prenatal cannabis use 6.25x
Evidence Grade:
Moderate: nationally representative survey with appropriate regression methods, but cross-sectional design and self-reported data, especially for a stigmatized behavior during pregnancy.
Study Age:
2026 publication analyzing NSDUH data from 2021-2023.
Original Title:
Cannabis use in pregnancy: Key findings from 2021-2023 National Survey on Drug Use and Health data.
Published In:
Addictive behaviors, 176, 108621 (2026)
Database ID:
RTHC-08722

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

How common is cannabis use during pregnancy in the U.S.?

About 7% of pregnant individuals reported current cannabis use. Among these users, 31% said their use was doctor-recommended and 52% purchased from a dispensary.

What predicts cannabis use during pregnancy?

The strongest correlates were serious psychological distress (6.25x odds), alcohol use (7.24x), and e-cigarette use (4.92x). Being younger, unmarried, and having higher education also increased odds. Perceiving risk from weekly cannabis use was strongly protective (93% reduced odds).

Read More on RethinkTHC

Cite This Study

RTHC-08722·https://rethinkthc.com/research/RTHC-08722

APA

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

MLA

Wysota, Christina N, et al. "Cannabis use in pregnancy: Key findings from 2021-2023 National Survey on Drug Use and Health data.." Addictive behaviors, 2026. https://doi.org/10.1016/j.addbeh.2026.108621

RethinkTHC

RethinkTHC Research Database. "Cannabis use in pregnancy: Key findings from 2021-2023 Natio..." RTHC-08722. Retrieved from https://rethinkthc.com/research/wysota-2026-cannabis-use-in-pregnancy

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.