Reported Reasons for Cannabis Use Before and After Pregnancy Recognition

Cannabis use is cautioned against during pregnancy, yet many pregnant people continue to use. This study aimed to evaluate the patterns and reasons for cannabis use before and after conception in pregnant people who screened positive for cannabis use at initiation of prenatal care.

Pregnant patients at 1 prenatal practice in Baltimore, MD, who either self-reported cannabis use or tested positive on urine toxicology were approached for enrollment. Those who consented were given an anonymous survey with multiple choice questions regarding frequency and reasons for use before and after pregnancy recognition. Fisher exact, χ 2 test, and analysis of variance were used for analysis.

Of 117 pregnant people approached, 105 enrolled in the study. Of the 105 respondents, 40 (38.1%) reported complete abstinence after pregnancy recognition, whereas 65 (61.9%) reported continued use. Of the respondents who continued cannabis use, 35 (53.8%) had decreased frequency of use or quit, 26 (40%) reported no change in frequency of use, and 4 (6.2%) reported increase in frequency of use. Those who considered their use medical or mixed before pregnancy were 4 times as likely to continue use compared with those who considered their use nonmedical (66.7% vs 33.3%; odds ratio, 4.0; 95% confidence interval, 1.3-12.8). Respondents who continued use after pregnancy recognition were significantly more likely to discuss their use with their obstetrician (89.2% vs 50%, P < 0.001).

Reasons for use frequently changed after recognition of pregnancy. Most people who continued use during pregnancy reported that their reasons were for symptom control.