Kaiser Permanente Northern California researchers studied 100,005 pregnancy records of 95,412 women before and during the COVID pandemic. They found that prenatal marijuana use increased 25 percent (from 6.75 percent to 8.14 percent) during the pandemic.
Cannabis use among pregnant women is common and has increased in recent years in the US, from an estimated 3.4% in 2002 to 7.0% in 2017.1 Pregnant women report using cannabis to relieve stress and anxiety,2 and prenatal cannabis use may have risen during the COVID-19 pandemic as pregnant women faced general and pregnancy-specific COVID-related stressors (eg, social isolation, financial and psychosocial distress, increased burden of childcare, changes in prenatal care, and concerns about heightened risks of COVID-19).3,4
Considered an essential business in California, cannabis retailers remained open during the pandemic with record sales in 2020.5 We used data from Kaiser Permanente Northern California (KPNC), a large integrated health care delivery system with universal screening for prenatal cannabis use to test the hypothesis that rates of prenatal cannabis use increased during the COVID-19 pandemic.
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Of 100 005 pregnancies (95 412 women), 26% were Asian or Pacific Islander; 7%, Black; 28%, Hispanic; 34%, non-Hispanic White; and 5%, other, unknown, or multiracial. The patients were a mean age of 31 years (median, 31 years). There were negligible differences in age or race and ethnicity in the 2 periods. During the pandemic, patients completed toxicology testing slightly earlier in their pregnancies (before pandemic mean, 8.51 weeks’ gestation; during pandemic mean, 8.04 weeks’ gestation).
Before the pandemic, the standardized rate of prenatal cannabis use was 6.75% of pregnancies (95% CI, 6.55%-6.95%); that rate increased to 8.14% of pregnancies (95% CI, 7.85%-8.43%) during the pandemic (Figure). In the ITS analysis, we found that prenatal cannabis use increased by 25% (95% CI, 12%-40%; Table) during the pandemic over prenatal cannabis use during the 15 months before the pandemic. The ITS analysis confirmed that these rates before and during the pandemic were stable, with no statistically significant month-to-month trends (Table).
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