Download PDF
Am J Perinatol 2024; 41(07): 902-908
DOI: 10.1055/a-1787-6889
Original Article

Exploration of Differences between Women Who Do and Do Not Disclose Their Marijuana Use during Pregnancy

Aaron W. Murnan 
1   Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
,
Sarah A. Keim
1   Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
2   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
3   Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio
,
Mark A. Klebanoff
1   Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
2   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
4   Center for Perinatal Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
5   Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
› Author Affiliations Funding The current study was funded by the National Institute on Drug Abuse (NIDA; grant number: R01DA042948); the March of Dimes Foundation (grant no.: 6-FY16-160); and the National Center for Advancing Translational Sciences/National Institutes of Health (grant number: UL1TR001070). The funding sources had no input in the study design; the data collection, interpretation, or analysis; the writing of this report; or the decision to submit the article for publication.
› Further Information
    Permissions and Reprints

Abstract

Objective This study aimed to explore demographic and health-related factors that may differentiate women who do and do not disclose their marijuana use during pregnancy.

Study Design The current study is a secondary analysis of data from a prospective cohort of pregnant women identified as using marijuana during pregnancy via a variety of assessment tools including self-report, urine screen, and obstetrics record abstraction. The cohort included a convenience sample of women recruited from several antenatal clinics at The Ohio State University Wexner Medical Center (OSUWMC). To be eligible, women needed to be within the first or second trimester of their pregnancy, 16 to 50 years of age, able to communicate in English, and intended to deliver at OSUWMC. Chi-square, independent samples t-tests, and logistic regression analyses were used to explore differences between those who did and did not disclose their use in relation to physical and mental health diagnoses, adverse experiences, use of other substances, and demographics.

Results Women who used marijuana during their pregnancy and had mental/physical health data available comprised the current sample (n = 109). Women who attended college were more likely to disclose their marijuana use compared with women who did not attend college (p < 0.001). Women who experienced homelessness (p < 0.01) or self-reported alcohol use during pregnancy (p < 0.001) were significantly more likely to disclose their marijuana use.

Conclusion Findings, suggesting disclosure of other substance use and adverse experiences, such as homelessness, may increase the likelihood that pregnant women will voluntarily disclose their marijuana use to providers. Findings did not reflect racial differences nor significant differences in mental/physical health status among women based on their disclosure. Future research with larger datasets is needed to build on these findings by confirming results, as well as exploring additional factors, that may more effectively differentiate women who are unlikely to disclose their prenatal marijuana use from those who do disclose their use.

Key Points

  • Women with higher education were more likely to self-disclose their prenatal marijuana use.

  • Women who experienced homelessness were more likely to self-disclose their prenatal marijuana use.

  • Self-disclosure of prenatal alcohol use was related to self-disclosure of prenatal marijuana use

Keywords

marijuana use - cannabis use - pregnancy - maternal disclosure


Publication History

Received: 18 February 2021

Accepted: 18 February 2022

Accepted Manuscript online:
03 March 2022

Article published online:
12 September 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Brown QL, Sarvet AL, Shmulewitz D, Martins SS, Wall MM, Hasin DS. Trends in marijuana use among pregnant and nonpregnant reproductive-aged women, 2002-2014. JAMA 2017; 317 (02) 207-209
    CrossrefPubMedGoogle Scholar
  • 2 Volkow ND, Han B, Compton WM, McCance-Katz EF. Self-reported medical and nonmedical cannabis use among pregnant women in the United States. JAMA 2019; 322 (02) 167-169
    CrossrefPubMedGoogle Scholar
  • 3 Ko JY, Farr SL, Tong VT, Creanga AA, Callaghan WM. Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age. Am J Obstet Gynecol 2015; 213 (02) 201.e1-201.e10
    CrossrefPubMedGoogle Scholar
  • 4 Chang JC, Tarr JA, Holland CL. et al. Beliefs and attitudes regarding prenatal marijuana use: Perspectives of pregnant women who report use. Drug Alcohol Depend 2019; 196: 14-20
    CrossrefPubMedGoogle Scholar
  • 5 Young-Wolff KC, Sarovar V, Tucker LY. et al. Validity of self-reported cannabis use among pregnant females in Northern California. J Addict Med 2020; 14 (04) 287-292
    CrossrefPubMedGoogle Scholar
  • 6 Sharapova SR, Phillips E, Sirocco K, Kaminski JW, Leeb RT, Rolle I. Effects of prenatal marijuana exposure on neuropsychological outcomes in children aged 1-11 years: A systematic review. Paediatr Perinat Epidemiol 2018; 32 (06) 512-532
    CrossrefPubMedGoogle Scholar
  • 7 American College of Gynecologists Committee on Obstetrics Practice. Committee opinion no. 722: marijuana use during pregnancy and lactation. Obstet Gynecol 2017; 130 (04) e205-e209
    CrossrefPubMedGoogle Scholar
  • 8 Terplan M, Kennedy-Hendricks A, Chisolm MS. Prenatal substance use: exploring assumptions of maternal unfitness. Subst Abuse 2015; 9 (Suppl. 02) 1-4
    PubMedGoogle Scholar
  • 9 Metz TD, Silver RM, McMillin GA. et al. Prenatal marijuana use by self-report and umbilical cord sampling in a state with marijuana legalization. Obstet Gynecol 2019; 133 (01) 98-104
    CrossrefPubMedGoogle Scholar
  • 10 Young-Wolff KC, Tucker LY, Alexeeff S. et al. Trends in self-reported and biochemically tested marijuana use among pregnant females in California from 2009–2016. JAMA 2017; 318 (24) 2490-2491
    CrossrefPubMedGoogle Scholar
  • 11 Klebanoff MA, Fried P, Yeates KO. et al. Lifestyle and Early Achievement in Families (LEAF) study: design of an ambidirectional cohort study of prenatal marijuana exposure and child development and behaviour. Paediatr Perinat Epidemiol 2020; 34 (06) 744-756
    CrossrefPubMedGoogle Scholar
  • 12 Klebanoff MA, Levine RJ, Morris CD. et al. Accuracy of self-reported cigarette smoking among pregnant women in the 1990s. Paediatr Perinat Epidemiol 2001; 15 (02) 140-143
    CrossrefPubMedGoogle Scholar
  • 13 Shulman HB, D'Angelo DV, Harrison L, Smith RA, Warner L. The pregnancy risk assessment monitoring system (PRAMS): overview of design and methodology. Am J Public Health 2018; 108 (10) 1305-1313
    CrossrefPubMedGoogle Scholar
  • 14 Foltz RL, McGinnis KM, Chinn DM. Quantitative measurement of delta 9-tetrahydrocannabinol and two major metabolites in physiological specimens using capillary column gas chromatography negative ion chemical ionization mass spectrometry. Biomed Mass Spectrom 1983; 10 (05) 316-323
    CrossrefPubMedGoogle Scholar
  • 15 Huang W, Moody DE, Andrenyak DM. et al. Simultaneous determination of delta9-tetrahydrocannabinol and 11-nor-9-carboxy-delta9-tetrahydrocannabinol in human plasma by solid-phase extraction and gas chromatography-negative ion chemical ionization-mass spectrometry. J Anal Toxicol 2001; 25 (07) 531-537
    CrossrefPubMedGoogle Scholar
  • 16 Quintela O, Andrenyak DM, Hoggan AM, Crouch DJ. A validated method for the detection of delta 9-tetrahydrocannabinol and 11-nor-9-carboxy- delta 9-tetrahydrocannabinol in oral fluid samples by liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry. J Anal Toxicol 2007; 31 (03) 157-164
    CrossrefPubMedGoogle Scholar
  • 17 Wilkins D, Haughey H, Cone E, Huestis M, Foltz R, Rollins D. Quantitative analysis of THC, 11-OH-THC, and THCCOOH in human hair by negative ion chemical ionization mass spectrometry. J Anal Toxicol 1995; 19 (06) 483-491
    CrossrefPubMedGoogle Scholar
  • 18 U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMSHA). Clinical Drug Testing in Primary Care. Technical Assistance Publication: TAP 32. : Rockville, MD: HHS Publication; 2012
    Google Scholar
  • 19 Klebanoff MA, Wilkins DG, Keim SA. Marijuana use during pregnancy and preterm birth: A prospective cohort study. Am J Perinatol 2021; 38 (S 01): e146-e154
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Mark K, Pierce E, Joseph D, Crimmins S. Interaction with the justice system and other factors associated with pregnant women's self-report and continuation of use of marijuana. Drug Alcohol Depend 2020; 206: 107723
    CrossrefPubMedGoogle Scholar