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?
Why are there racial disparities?
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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