Why should pregnant women be screened for cannabis use at their first prenatal visit?

With the legalization of recreational and medical cannabis in many states, the incidence of cannabis use in pregnancy is increasing as well. A recent studysheds light on some issues related to cannabis use in pregnant women. Kaiser Permanente Northern California (KPNC) is a large integrated health care system, which provides universal screening for prenatal cannabis use. Patients self-report and submit to urine toxicology testing. Women who tested positive were used in this cross-sectional study to examine the association of depression, anxiety, and trauma diagnoses and symptoms with prenatal cannabis use.

The investigators looked at almost 200,000 women and found 6% of them screened positive for cannabis use in early pregnancy. Investigators identified “Depression, anxiety, and trauma diagnoses and symptoms were associated with higher odds of cannabis use among pregnant women in California. These results support previous qualitative findings that pregnant women self-report using cannabis to manage mood and stress and suggest a dose-response association, with higher odds of cannabis use associated with co-occurring depressive and anxiety disorders and greater depression severity.”

This data is useful to obstetricians and others who provide care to pregnant women. Women who use cannabis pre-conception and during pregnancy are more likely to suffer from depression, anxiety, other mental health and social concerns.

We also know there is no safe amount of cannabis that can be used in pregnancy and there may be real danger to a developing fetal brain when exposed to cannabis.

Simple, compassionate screening for cannabis use in early pregnancy can help us identify women and babies at risk. Women with mental, emotional and social conditions can be identified and treated as necessary. Women can be educated about potential fetal risk and additional resources can be recruited to improve the overall well-being of our mothers and babies.

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