Cannabis use in pregnancy: Key findings from 2021-2023 National Survey on Drug Use and Health data.
Level 4 - case-series / case-control
Cross-sectional survey analysis
PubMed 41643368 · doi:10.1016/j.addbeh.2026.108621
What was done
Researchers analyzed pooled cross-sectional data from 1,992 pregnant participants in the U.S. National Survey on Drug Use and Health (NSDUH) between 2021 and 2023. Multinomial logistic regression was used to evaluate sociodemographic, substance use, and clinical correlates of cannabis use status, comparing never users against current (past 30-day), recent (past 2–12 months), and former (non-use in past year) users.
What was found
Nearly 7% of pregnant respondents reported current cannabis use. Among current users, 31% reported doctor-recommended use in the past year and 52% purchased cannabis from a dispensary. Relative to never users, current cannabis use was significantly higher among individuals aged 18–25 years (Relative Risk Ratio [RRR] = 2.08, 95% CI: 1.04–4.18), unmarried participants (RRR = 2.54, 95% CI: 1.05–6.14), those with higher education compared to less than high school (RRR = 2.97, 95% CI: 1.42–6.23), and those with past 30-day cigarette use (RRR = 2.57, 95% CI: 1.11–5.94), alcohol use (RRR = 7.24, 95% CI: 1.52–34.49), e-cigarette use (RRR = 4.92, 95% CI: 1.71–14.10), or serious psychological distress (RRR = 6.25, 95% CI: 2.46–15.85). Perceiving some risk from weekly cannabis use was associated with lower current use (RRR = 0.07, 95% CI: 0.03–0.14). Recent use versus never use was lower in states where cannabis was illegal (RRR = 0.45, 95% CI: 0.22–0.95).
Why it matters
These findings identify key risk profiles—notably co-occurring substance use, mental health distress, and low risk perception—that can inform targeted clinical screening and prenatal counseling as cannabis access expands.
Limits
The cross-sectional design cannot establish causality or determine if cannabis use preceded or followed pregnancy recognition. All measures rely on self-reported survey data without biological validation (e.g., toxicology screening), creating potential for underreporting due to social desirability or legal concerns. Specific gestational timing, dosages, and fetal outcomes were not evaluated.
Cited by
- contradicts Approximately 15% of pregnant women in the United States report using cannabis in some form during pregnancy.