More women use cannabis before and during pregnancy, according to Kaiser Permanente

More women use cannabis before and during pregnancy, according to Kaiser Permanente

According to new data from Kaiser Permanente, the number of women who use cannabis before and during pregnancy is increasing, as is the frequency of their use.

A study published in the JAMA Network Open magazine on 19 July 2019 looked at reported cannabis use among 276,991 pregnant women (representing 367,403 pregnancies) in Northern California over a 9-year period and found that cannabis use had increased over time.

Between 2009 and 2017, the adjusted prevalence of self-reported cannabis use increased from 6.8% to 12.5% ​​in the year before pregnancy, and the adjusted prevalence of self-reported cannabis use during pregnancy increased from 1.9% to 3.4%. (rates adjusted for demographics). The annual changes in daily, weekly and less than monthly cannabis use reported by cannabis itself increased significantly, although daily use grew the fastest.

Among women who reported using cannabis themselves during the pre-pregnancy year, the proportion of daily users increased from 17% to 25% and the proportion of weekly users increased from 20% to 22%, while the proportion of monthly or less users decreased to 63%. up to 53% during the study period. Similarly, the proportion of women who used cannabis during pregnancy increased from 15% to 21% and the proportion of weekly users from 25% to 27%, while the proportion of monthly users fell from 60% to 52%.

Kelly Young-Wolff, Research Fellow, Research Department.

"These findings should alert female health physicians to be aware of the potential increase in daily and weekly cannabis use among these patients," said lead author Kelly Young-Wolff, PhD, MPH, a researcher in Kaiser's Permanente Research Department. "The actual number is likely to be higher because women are reluctant to disclose the use of their substances to their medical users."

In addition, the prevalence of daily and weekly cannabis use over the past year and a half may increase further after the legalization of cannabis for recreational use in California in 2018, Young-Wolff said.

The data come from women's first prenatal visits to the Kaiser Permanente in Northern California, which usually take place around eight weeks of gestation and do not reflect continued use throughout pregnancy. The researchers were unable to distinguish whether cannabis use during pregnancy occurred before or after women became aware that they were pregnant.

While current findings are based on women's self-reports, the results are supported by a December 2017 JAMA study by the Kaiser Permanente research team showing an increase in prenatal cannabis use through urinary toxicological tests. In this more recent study, the authors focus on trends in the frequency of use in the pre-pregnancy year and during pregnancy.

Some women may use cannabis during pregnancy to relieve morning sickness, the authors noted. The authors' previous work in JAMA internal medicine in 2018 found that women with severe nausea and vomiting used cannabis almost four times more often during the first trimester of pregnancy.

Women may get the impression from marketing cannabis products and online media that cannabis use is safe during pregnancy, Young-Wolff said. However, there is ample evidence that cannabis exposure during pregnancy is associated with a low birth weight child, and the American College of Obstetricians and Gynecologists recommends that pregnant women or women planning to become pregnant stop using cannabis because of concerns about nervous system development and smoking.

"Much remains to be known on this topic, including what types of cannabis products are used by pregnant women and whether health effects vary according to the way cannabis is used and the frequency with which prenatal cannabis is used," Young-Wolff said.

More research is needed to provide better and more specific advice to women, said study author Nancy Goler, obstetrician / gynecologist and CEO of The Permanente Medical Group.

"There is an urgent need to better understand the effects of prenatal cannabis exposure, as cannabis is legalized in more states and more widely accepted and used," said Dr. Goler. "Until we fully understand the specific health risks of cannabis for pregnant women and their fetuses, we recommend stopping all cannabis use before becoming pregnant, and certainly if the woman knows she is pregnant."

The study was supported by support from the National Institute on Drug Abuse.

Young-Wolff and researcher Lindsay Avalos, PhD, MPH, Kaiser Permanente, have received a new 5-year scholarship from NIDA to support further research into the use of maternal cannabis during pregnancy. They intend to investigate whether prenatal cannabis use is associated with an increased risk of adverse outcomes in females, fetuses, and neonates, using data from urinary toxicology studies, the frequency of prenatal cannabis use, and the patterns of cannabis use. They will also test whether the legalization of cannabis for recreational use in 2018 and local regulatory practices (such as retailer bans) are linked to differences in prenatal cannabis use.

Additional authors included Constance Weisner, DrPH, MSW, Varada Sarovar, PhD, Lue-Yen Tucker, Mary Anne Armstrong, MA, and Stacey Alexeeff, PhD, Kaiser Permanente of the Northern California Department of Science; and Amy Conway, MPH, Kaiser Permanente of the Northern California Early Start Program.

[…] More women who use cannabis every day before and during pregnancy can be found in the Kaiser Permanente study at https://spotlight.kaiserpermanente.org/more-pregnant-women-using-cannabis-daily/ […]

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