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Study breakdown

Prenatal Cannabis Use Nearly Doubled From 2012 to 2022, With Persistent Racial and Age Disparities

Cross SectionalStrong evidence
The takeaway

Prenatal cannabis use prevalence increased from 5.5% in 2012 to 9.0% in 2022 across a large California health system, with the highest rates among Black individuals and those aged 13-24 throughout the decade.

Prenatal care providers; public health researchers tracking cannabis use trends.

5.5% to 9.0% prenatal cannabis use from 2012 to 2022 (aPR 1.82)

What the researchers found

Prenatal cannabis use prevalence increased from 5.5% to 9.0% (aPR 1.82). Similar increases were seen by toxicology test (aPR 1.70) and self-report (aPR 2.12). The increase varied significantly by race/ethnicity and age, with the highest prevalence consistently among Black individuals and those aged 13-24. Although rates increased more slowly in these groups, disparities persisted.

Why it matters

The near-doubling of prenatal cannabis use over a decade coincides with legalization and increasing social acceptance. Persistent disparities by race and age highlight that the public health impact of rising prenatal cannabis use is not equally distributed, requiring targeted intervention strategies.

The numbers in context

Overall increase: 5.5% (2012) to 9.0% (2022), aPR 1.82 (1.72-1.92). By toxicology: aPR 1.70 (1.60-1.81). By self-report: aPR 2.12 (1.95-2.30). Highest prevalence among Black individuals and ages 13-24 across all years. Sample sizes: 33,546 (2012), 43,415 (2022).

How the study worked

Population-based cross-sectional study analyzing electronic health records from Kaiser Permanente Northern California. Compared prenatal cannabis use in 2012 (n=33,546) to 2022 (n=43,415) using self-report and urine toxicology testing during standard prenatal care. Adjusted prevalence ratios calculated.

What this study cannot tell us

Single California health system with universal screening may not represent settings without routine screening. The study compared two time points rather than tracking continuous trends. Prenatal cannabis use at one screening point may not capture full pregnancy exposure.

How to read the evidence

Strong: large population-based study with universal objective screening (both self-report and toxicology) across a decade, with adjusted analyses.

When this study was published

2024 study using 2012-2022 data.

The bigger picture

Self-reported use increased faster than toxicology-detected use (aPR 2.12 vs 1.70), which could reflect reduced stigma making pregnant individuals more willing to disclose cannabis use, or increased awareness of screening programs. Either way, the trend toward greater openness could improve clinical conversations.

Questions still open

  • Have the disparities narrowed or widened since 2022? What proportion of the increase reflects higher THC potency products versus more frequent use? Do screening-and-counseling programs effectively reduce prenatal cannabis use?

Common questions

Why is prenatal cannabis use increasing?
Multiple factors likely contribute: cannabis legalization, increased social acceptance, declining risk perception, wider product availability, and possibly more willingness to report use. The faster increase in self-reported vs. toxicology-detected use suggests reduced stigma plays a role.
Why are there racial disparities?
The study did not determine specific causes, but factors may include different stress exposures, cultural attitudes, access to alternative coping resources, and targeted marketing. Importantly, while these groups had the highest rates, the increases were somewhat slower, indicating the gap could potentially narrow with sustained intervention.

Read the original research

Changes in Prenatal Cannabis Use Among Pregnant Individuals From 2012 to 2022.

Obstetrics and gynecology, 144(4), e101-e104

Citation

Young-Wolff, Kelly C; Chi, Felicia W; Lapham, Gwen T; Alexeeff, Stacey E; Does, Monique B; Ansley, Deborah; Campbell, Cynthia I. (2024). Changes in Prenatal Cannabis Use Among Pregnant Individuals From 2012 to 2022.. Obstetrics and gynecology, 144(4), e101-e104. https://doi.org/10.1097/AOG.0000000000005711

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