Using data from the National Survey of Drug Use and Health between 2002 and 2016, researchers sought to study changes in the use of alcohol, cigarette, and cannabis during pregnancy in a nationally representative sample of women aged 18 to 44 years.

Of the 12,988 pregnant women in this cohort, only women aged 18 to 25 years (n?=?8170) or 26 to 44 years (n?=?3888) were included in the analyses. Of these 12,058 women, 3554 women reported being in their first trimester of pregnancy.  The prevalence of alcohol use declined from 9.59% in 2002 to 8.43% in 2016.  The prevalence of cigarette use decreased even more, going from 17.5% in 2002 to 10.3% in 2016.

In contrast, the use of cannabis nearly doubled over this time period, rising from 2.85% in 2002 to 4.98% in 2016.  The data reflect an overall increase in the use of marijuana among Americans.  Over the last decade, marijuana use among US adults has more than doubled, as many states have legalized marijuana use and attitudes toward marijuana have become more permissive.


The American College of Obstetricians and Gynecologists (ACOG) has issued a committee opinion on the use of marijuana in pregnant and nursing women, calling for ob-gyns to urge their patients who are pregnant or contemplating pregnancy to discontinue marijuana use.  Nonetheless, many pregnant women using marijuana have not been informed of its risks, and women may be misinformed regarding the safety and effectiveness of cannabis use to manage a variety of symptoms, including morning sickness, insomnia and anxiety during pregnancy.

Unfortunately we know very little about the effects of prenatal exposure to marijuana, but there are a fair number of studies which suggest that cannabis may pose significant risks to the developing fetus.  Clearer greater public awareness regarding the consequences of prenatal exposure to cannabis must be a priority.

Ruta Nonacs, MD PhD

Alcohol, Cigarette, and Cannabis Use Between 2002 and 2016 in Pregnant Women From a Nationally Representative Sample.

Agrawal A, Rogers CE, Lessov-Schlaggar CN, Carter EB, Lenze SN, Grucza RA.  JAMA Pediatr. 2018 Nov 5.



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