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

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.

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.

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.

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.

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.