Study Examines Prevalence of Cannabis Use Disorder in Pregnant Women in US

A recently published study (1) examined cannabis use disorder (CUD) rates in pregnant women in the US over five years. As noted in the study’s introduction, cannabis legalization has increased, with 24 states and Washington DC passing laws for recreational cannabis by the end of the study period, along with medical cannabis being legal in 39 states and Washington DC. The study, “Cannabis use disorder among insured pregnant women in the U.S., 2015-2020,” was published in February 2025 in the American Journal of Preventive Medicine.

The study noted prior data on pregnant women in the US from previous self-reported survey indicating that past-month cannabis use had increased from 1.5% to 5.4% from 2002 to 2020. It also noted one study of 46 pregnant women in Maryland who qualified for CUD at delivery based on positive urine tests for cannabis, a universal test taken at hospital admission.

To examine data on CUD and pregnancies, the current study used data from MerativeMarketscan Commercial Claims and Encounters Database from Q4 2015–Q4 2020, identifying 1,058,448 total pregnancies.

Highlighted results include (1):

• The cumulative prevalence of CUD diagnosis was 0.26% (N=2,727)
• Annual prevalences ranged from 0.22% in 2015 to 0.26% in 2020

“While earlier research analyzed data from a specific geographic sample of pregnant women, this study aimed to examine the prevalence of CUD diagnosis during pregnancy among a large sample of commercially insured women determined from commercial administrative claims data during a five-year period,” stated study author Priscila Gonçalves, PhD, assistant professor in the Department of Psychiatry, Columbia University Irving Medical Center, in a March 31 press release (2).

Some limitations to the study included reduced generalizability due to the restricted sociodemographic information of the study group and requirement to be continually enrolled in commercial insurance, as well as the possibility of a CUD diagnosis prior to pregnancy.

“Our results highlight the need to better understand the determinants of CUD among pregnant women, including factors related to CUD diagnosis—from the severity of CUD—as well as factors contributing to diagnosis and treatment,” added study author Silvia Martins, MD, PhD, professor of Epidemiology at Columbia Mailman School. “This study makes it clear that additional research is needed to inform prevention and intervention opportunities.”

The study received funding from National Institute on Drug Abuse of the National Institutes of Health.

A study published in January 2025 examined whether signs warning of potential adverse health effects from cannabis use during pregnancy were effective deterrents. This study involved 34 participants ages 18–49 from states with differing laws concerning cannabis. The participants had indicated cannabis use before or during pregnancy.

The study tested 29 warning message types (abstinence based, informational, normalization, harm reduction, legal, autonomy), asking participants to react to the messages. Overall, the participants reported negative or mixed views of the warning signs they were shown. About 40% viewed the messages as having a positive deterrent effect, though only three of these participants did not also mention an accompanying potential negative effect. The participants’ responses were seemingly not affected by their cannabis policy environment.

References

1. Dib Goncalves, P.; Philbin, MM.; Fan, W.; Huang, Y.; Marziali, ME.; Bruzelius, E.; Segura, LE.; Mauro, PM.; Martins, SS. Cannabis use disorder among insured pregnant women in the U.S., 2015-2020., American Journal of Preventive Medicine. 2025. DOI: 10.1016/j.amepre.2025.02.011.
2. Columbia University Mailman School of Public Health. Cannabis Use Disorder Diagnoses Rise Among Pregnant Women as Legalization Expands. https://www.publichealth.columbia.edu/news/cannabis-use-disorder-diagnoses-rise-among-pregnant-women-legalization-expands (accessed April 9, 2025).