Frequency of cannabis use during pregnancy and adverse infant outcomes, by cigarette smoking status - 8 PRAMS states, 2017.

Abstract Background Research on prenatal cannabis use and adverse infant outcomes is inconsistent, and findings vary by frequency of use or cigarette use. We assess (1) the prevalence of high frequency (≥once/week), low frequency ( Methods Cross-sectional data from 8 states’ 2017 Pregnancy Risk Assessment Monitoring System (n = 5548) were analyzed. We calculated adjusted prevalence ratios (aPR) between cannabis use frequency and infant outcomes with Modified Poisson regression. Results Approximately 1.7 % and 2.6 % of women reported low and high frequency prenatal cannabis use, respectively. Prevalence of use was higher among women with small-for-gestational age (SGA) (10.2 %) and low birthweight (9.7 %) deliveries, and cigarette use during pregnancy (21.2 %). Among cigarette smokers (aPR: 1.8; 95 % CI: 1.1−3.0) and non-smokers (aPR: 2.1; 95 % CI: 1.1−3.9), high frequency cannabis use doubled the risk of low birthweight delivery but did not increase preterm or SGA risk. Regardless of cigarette use, low frequency cannabis use did not significantly increase infant outcome risk. Conclusions Prenatal cannabis use was more common among women who smoked cigarettes during pregnancy. High frequency cannabis use was associated with low birthweight delivery, regardless of cigarette use. Healthcare providers can implement recommended substance use screening and provide evidence-based counseling and cessation services to help pregnant women avoid tobacco and cannabis use.