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Recreational Cannabis Legalization in the US and Maternal Use during the Preconception, Prenatal, and Postpartum Periods

Author

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  • Kara R. Skelton

    (Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway Baltimore, MD 21205, USA)

  • Amelie A. Hecht

    (Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway Baltimore, MD 21205, USA)

  • Sara E. Benjamin-Neelon

    (Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway Baltimore, MD 21205, USA)

Abstract

In the United States (US), recreational cannabis use is on the rise. Since 2011, 11 states and the District of Columbia have legalized cannabis for adult recreational use. As additional states consider legalizing, there is an urgent need to assess associations between recreational cannabis legalization and maternal use in the preconception, prenatal, and postpartum periods—all critical windows for maternal and child health. Using cross-sectional data from the 2016 Pregnancy Risk Assessment Monitoring System, we assessed associations between state cannabis legalization and self-reported maternal cannabis use. Using logistic regression, we estimated the adjusted prevalence ratio (PR) of cannabis use during the preconception, prenatal, and postpartum period for women delivering a live-born infant in three states that had legalized recreational cannabis (Alaska, Colorado, and Washington) and three states that had not legalized (Maine, Michigan, and New Hampshire) by 2016. Our final sample size was 7258 women. We utilized 95% confidence intervals (CI) and a significance level of alpha = 0.05. After adjustment for potential confounders, women who resided in states with legalized recreational cannabis were significantly more likely to use cannabis during the preconception (PR 1.52; 95%CI ranging from 1.28–1.80; p < 0.001), prenatal (PR 2.21; 95% CI ranging from 1.67–2.94; p < 0.001), and postpartum (PR 1.73; 95%CI ranging from 1.30–2.30; p < 0.001) periods, compared to women who resided in states without legalized recreational cannabis. Although evidence about the effect of marijuana use during these periods is nascent, these findings show potential for increased incidence of child exposure to cannabis. Longitudinal research is needed to assess immediate and sustained impacts of maternal use before and after state legalization of recreational cannabis.

Suggested Citation

  • Kara R. Skelton & Amelie A. Hecht & Sara E. Benjamin-Neelon, 2020. "Recreational Cannabis Legalization in the US and Maternal Use during the Preconception, Prenatal, and Postpartum Periods," IJERPH, MDPI, vol. 17(3), pages 1-11, February.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:3:p:909-:d:315318
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    References listed on IDEAS

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    1. Ghosh, T. & Dyke, M.V. & Maffey, A. & Whitley, E. & Gillim-Ross, L. & Wolk, L., 2016. "The public health framework of legalized marijuana in Colorado," American Journal of Public Health, American Public Health Association, vol. 106(1), pages 21-27.
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    Cited by:

    1. Christie Sennott & Sadé L. Lindsay & Brian C. Kelly & Mike Vuolo, 2022. "The Liberalization of Cannabis Possession Laws and Birth Outcomes: A State-Level Fixed Effects Analysis, 2003–2019," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 41(4), pages 1809-1829, August.

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