Study Reveals Lack of Counseling on Marijuana Use During Pregnancy Despite Reported Usage: ACOG annual meeting

The study revealed that women who used marijuana during pregnancy were significantly less likely to view it as risky, even in a state where it was not legalized. However, most of those women had not received any counseling about stopping its use, and more than half wanted more information about its impact on pregnancy complications.

The findings were presented at the annual clinical and scientific meeting of the American College of Obstetricians and Gynecologists.

An estimated 3%-30% of pregnant women use marijuana, depending on the population, but there has been an increase in prevalence as more states legalize its use. Yet research has shown an association between marijuana use during pregnancy and multiple neonatal complications, including low birth weight and fetal growth restriction.

During the prenatal visits, pregnant women at a single center in Arkansas were invited to complete a 35-question, anonymous survey electronically or on paper. Of the 460 approaches, 88.7% completed the survey, and 11.8% of those women reported marijuana use during pregnancy. Among those who used it while pregnant, 50% reported using it 2-3 times a week, 18.8% reported using it daily, and 27% reported using it once weekly.

The other questions asked respondents on a 5-point Likert scale how much they disagreed or agreed with several statements related to perceptions of marijuana, its use during pregnancy, and its risks.

The following were the key findings of the study:

· The women who used it while pregnant were less likely to have a college degree, and half (50%) were aged 18-24, with use declining with increasing age.

· More than half of the women (52.7%) who used marijuana during pregnancy reported that there had not been any discussion about substance use during pregnancy at the prenatal visit, and 82.4% said they had not received any counseling about stopping its use during pregnancy. Yet 54% of them wanted more information about pregnancy complications linked to cannabis use.

· Most respondents strongly agreed that “marijuana isn’t as bad as other drugs like heroin, cocaine or meth,” but the average agreement was higher among those who used marijuana (4.88) than those who didn’t (4.02).

· Respondents largely neither agreed nor disagreed with its being okay to use marijuana during pregnancy with a prescription, but agreement was still higher among those who used it (3.68) than didn’t use it (2.82).

· Those who used marijuana were more likely to agree that it’s “a natural substance and not a drug” (4.67 versus 3.38); to believe “marijuana has minimal health risks during and outside of pregnancy” (4.15 versus 2.96), and to believe “marijuana has less risk for treating symptoms in pregnancy than prescription medication from my provider” (4.19 versus 3.01).

In a separate poster, Sarah Dzubay, BS, of Oregon Health & Science University, Portland, presented data examining potential associations between cannabis use and fertility. Previous research has suggested an association, but the cross-sectional analysis by Ms. Dzubay identified only a nonsignificant trend toward an association.

The researchers analyzed data from the 2013-2018 National Health and Nutrition Examination Study (NHANES) for women aged 20-49 based on self-reported use of cannabis. Among 3166 women, 51% reported never using cannabis, 29% reported irregular use, and 20% reported regular use at least monthly.

“Women reporting regular use were younger, of lower income and educational attainment, and more likely to be single,” Ms. Dzubay reported. Those reporting irregular use, meanwhile, were more likely to be college graduates.

More of the women who used cannabis regularly (15.4%) reported an inability to conceive within one year than women who used cannabis irregularly (10.8%) or never (12.6%). The higher odds ratio of infertility among those using cannabis regularly (OR 1.47) compared to never using it was not statistically significant, however, nor was the reduced odds ratio among those using it irregularly (OR 0.83).

Because the results were not significant, the possibility of a link to infertility is “something to keep in mind,” Ms. Dzubay said, but “a lot more data has to be collected about this question before we can definitively say there’s a risk.”