Variation in Hospital Practices Regarding Marijuana Use in Pregnancy and Lactation.

Area of Science:

• Perinatal health
• Neonatal care
• Public health policy

Background:

• Limited evidence exists on the safety of fetal and neonatal marijuana (MJ) exposure.
• Current professional guidelines for MJ exposure during pregnancy and postpartum are inconsistent.
• Hospital practices regarding mother's own milk (MOM) use in neonates exposed to MJ are not well-documented.

Purpose of the Study:

• To examine variations in U.S. hospital practices concerning the use of mother's own milk (MOM) following perinatal marijuana (MJ) exposure.
• To assess how hospital location and state MJ legal status influence these practices.
• To identify disparities in hospital policies and clinical practices related to maternal MJ use.

Main Methods:

• A cross-sectional electronic survey was distributed to U.S. perinatal healthcare workers from November 2021 to April 2022.
• Survey responses were analyzed based on state MJ legalization status: recreational (REC), medical only (MED), and non-legal (NON).
• Data from 2,683 respondents across all 50 states and D.C. were included.

Main Results:

• Significant differences in hospital policies and practices were observed between states with legal recreational MJ (REC) and non-legal MJ (NON) states.
• Facilities in REC states were more likely to permit MOM use by mothers using MJ postpartum.
• REC states were less likely to routinely test for cannabinoids, and policies varied between well-baby nurseries and NICUs.

Conclusions:

• Hospital practices regarding MOM provision for neonates with maternal MJ exposure differ substantially based on state legalization status and hospital unit.
• There is a need for standardized guidelines from professional organizations on perinatal MJ exposure, irrespective of legal status.
• Improved guidelines can enhance care consistency and patient education on MJ use during pregnancy and postpartum.