TUESDAY, Nov. 5, 2024 (HealthDay News) — The implementation of recreational cannabis legalization (RCL) in California was associated with an increase in prenatal cannabis use, according to a study published online Nov. 1 in JAMA Health Forum.

Kelly C. Young-Wolff, Ph.D., from Kaiser Permanente Northern California in Pleasanton, and colleagues assessed whether RCL in California was associated with changes in prenatal cannabis use rates detected via both self-report and urine toxicology testing. The analysis included universal screening results for cannabis use during early pregnancy from 300,993 pregnancies (236,327 unique individuals) from 2012 through 2019.

The researchers found that before RCL implementation, rates of prenatal cannabis use rose steadily from 4.5 percent in January 2012 to 7.1 percent in January 2018. At the time of RCL passage (Nov. 9, 2016), there was no change in use rates (level change rate ratio [RR], 1.03; 95 percent confidence interval [CI], 0.96 to 1.11). However, there was a statistically significant increase in rates in the first month after RCL implementation (January 2018), increasing to 8.6 percent in February 2018 (level change RR, 1.10). Similar results were seen for prenatal cannabis use detected via toxicology test or self-report. The post-RCL implementation increase in use was only seen in jurisdictions allowing adult-use cannabis retailers (allowed: RR, 1.21 [95 percent CI, 1.10 to 1.33]; banned: RR, 1.01 [95 percent CI, 0.93 to 1.10]).

“Clinicians can provide education to all patients during the preconception and prenatal periods about the potential risks associated with prenatal cannabis use so that patients can make well-informed decisions,” the authors write.

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