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Prevalence of Cannabis Use Disorder in Insured Pregnant Women in the U.S. (2015-2020)

March 31, 2025
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Cannabis use among pregnant women has emerged as a growing concern in public health, with a significant rise in usage documented by researchers from Columbia University Mailman School of Public Health and the Columbia University Irving Medical Center. The increase is particularly alarming, as previous studies indicated that the prevalence of cannabis consumption among pregnant women in the United States has more than tripled from 2002 to 2020. Specifically, self-reported usage climbed from 1.5 percent to 5.4 percent over the 18-year study period, raising questions about the impacts of this trend on maternal and neonatal health. The findings have been published in the esteemed American Journal of Preventive Medicine, underlining the urgent need for awareness and intervention.

Medical guidelines typically advise pregnant women to abstain from cannabis use, highlighting its association with a range of adverse outcomes. These include increased risks for both mothers and newborns, as well as potential long-term impacts on mental health for both parties. The long-term effects of prenatal exposure to cannabis are an area of study that necessitates further exploration to ensure expectant mothers receive accurate and comprehensive guidance regarding this substance. The rise in cannabis usage during pregnancy could be attributed to changing social perceptions regarding cannabis, especially as more states legalize its use for medicinal and recreational purposes.

The present research focused on diagnosing cannabis use disorder (CUD) among pregnant women during the years 2015 to 2020. The team analyzed data obtained from the Merative™ Marketscan® Commercial Claims and Encounters Database, which included a wide demographic of pregnant women between the ages of 12 and 55 with continuous insurance enrollment. Utilizing the International Classification of Diseases codes, they identified cases of cannabis use disorder, shedding light on the extent of this condition within their study group.

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In total, the researchers identified 893,430 pregnant women, leading to a reported 1,058,448 pregnancies. Alarmingly, the cumulative prevalence of cannabis use disorder diagnoses among this population was recorded at 0.26%, with yearly prevalence fluctuating slightly from 0.22% in 2015 to 0.27% in 2018 and 2019. These figures reveal that cannabis use disorder, although appearing relatively low in prevalence, poses a significant risk for the health and well-being of both mothers and their infants. The gradual increase in such cases merits further investigation to identify the root causes and potential risk factors contributing to these diagnoses.

Dr. Priscila Gonçalves, an assistant professor in the Department of Psychiatry at Columbia University Irving Medical Center and the study’s first author, noted that earlier research concentrated on smaller geographic samples of pregnant women. In contrast, this study analyzed an extensive dataset representing commercially insured women across the United States. The diversity of the participants helps ensure that the findings are more universally applicable, providing a clearer picture of the prevalence of CUD during pregnancy.

With the legalization of cannabis for medical use in 34 states and Washington D.C. as of 2020, its potential medicinal properties have attracted attention. Many pregnant women may be self-medicating to alleviate conditions such as nausea, which is common during pregnancy. However, it might also indicate that a number of these women meet criteria for cannabis use disorder. Although cannabis may seem to offer relief for certain pregnancy-related symptoms, the associated risks often outweigh the potential benefits.

Clinicians who regularly engage with pregnant women are ideally positioned to address issues related to cannabis use. However, they may lack the structural support necessary to implement effective interventions targeting cannabis use and cannabis use disorder. Importantly, the fear of legal repercussions can also inhibit women from disclosing their substance use, further underestimating the prevalence of CUD and complicating clinician efforts to provide medically appropriate interventions.

The results of this study underscore the pressing need for more comprehensive understanding concerning the determinants of CUD among pregnant women. Understanding the severity of cannabis use disorder and the factors contributing to its diagnosis and treatment could significantly enhance the quality of care received by pregnant women. Dr. Silvia Martins, a professor of Epidemiology at Columbia Mailman School and the study’s senior author, emphasized the need for additional research in this area, which could help identify effective prevention and intervention opportunities for pregnant individuals.

Furthermore, it is critical to recognize that rising cannabis use among pregnant women not only impacts the individuals involved but also poses broader implications for public health policies and maternal health practices. The studies conducted by the Columbia research team will likely serve as a catalyst for further inquiry into the relationship between cannabis use and pregnancy outcomes. Specifically, understanding how various public health and social factors interact with maternal substance use could lead to more tailored interventions.

As journalists and researchers continue to unpack the complexities surrounding cannabis use during pregnancy, public health officials must also consider the socio-economic factors influencing women’s choices. Knowing that personal, cultural, and geographic factors can play significant roles, comprehensive strategies need to be adopted to address the increasing cannabis usage trend in this vulnerable demographic. Hence, initiatives must not only focus on legal policies but also on educational campaigns aimed at modifying perceptions and increasing awareness regarding safer practices during pregnancy.

Despite the existing body of knowledge, there remains much to learn about the nuanced relationship between cannabis and pregnancy. As the legal status of cannabis continues to change across states, ongoing research is paramount in ensuring that both healthcare providers and expectant mothers are equipped with the latest evidence-based guidelines. Protecting maternal and infant health should remain a priority as society adapts to changing views and regulations surrounding cannabis.

In conclusion, the growing prevalence of cannabis use among pregnant women is a pressing public health concern that warrants increased attention and research. The emphasis placed by researchers at Columbia University on cannabis use disorder during pregnancy represents a crucial step in understanding this issue more profoundly. As further studies unfold, it is imperative to remain vigilant, prioritize maternal health, and pave the way for evidence-based practices that will safeguard the well-being of mothers and their children alike.

Subject of Research: Cannabis use disorder among pregnant women
Article Title: Cannabis use disorder among insured pregnant women in the U.S., 2015-2020
News Publication Date: October 2023
Web References: www.mailman.columbia.edu
References: American Journal of Preventive Medicine
Image Credits: Columbia University Mailman School of Public Health

Keywords: Cannabis use, pregnancy, maternal health, cannabis use disorder, public health

Tags: awareness and intervention for cannabis usecannabis and mental health outcomescannabis usage trends 2015-2020cannabis use disorder in pregnant womenchanging social perceptions of cannabisColumbia University cannabis researchlong-term effects of prenatal cannabis exposurematernal health and cannabis usemedical guidelines for pregnant womenneonatal health risks of cannabisprevalence of cannabis use in pregnant womenpublic health concerns cannabis pregnancy
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