A team of University of Arkansas for Medical Sciences (UAMS) researchers is working to provide the first population-level look at how pregnant women in Arkansas purchase medical cannabis and how those purchasing patterns change throughout pregnancy.
The study, “From Card to Cradle: Examining Medical Cannabis Purchasing Among Pregnant Women in Arkansas,” was recently published in the American Journal of Obstetrics & Gynecology MFM and represents a key step toward understanding the potential effects of cannabis exposure on mothers and babies.
Researchers examined 72,992 pregnancies in Arkansas from May 2019 to August 2022 using state- and nationwide records to create a dataset that allowed them to study cannabis purchasing before and during pregnancy. (In Arkansas, medical cannabis was legalized in 2016, and the first dispensary opened on May 11, 2019.)
The study shows that 1.62% or 1,185 of Arkansas pregnancies during that time involved medical cannabis purchases.
“Among women who used medical cannabis, about two-thirds continued purchasing both before and during pregnancy, while about one-third started purchasing during pregnancy,” said Nahed O. ElHassan, MD, PhD, MPH, the study’s first author and a professor of pediatrics in the Division of Neonatology at UAMS who treats patients in the Neonatal Intensive Care Unit at Arkansas Children’s Hospital.
“A smaller group of women who had purchased cannabis before pregnancy stopped once pregnancy began. We also found that cannabis purchasing occurred during all trimesters of pregnancy,” she added.
The findings are important because both the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics recommend discontinuing cannabis during pregnancy, given limited safety data and the absence of any FDA-approved indications for cannabis use in pregnancy.
“In clinical practice, we do see pregnant women using cannabis, but there is still limited and sometimes unclear evidence about how it may affect mothers and babies,” said ElHassan, who recently completed a PhD in Pharmaceutical Evaluation and Policy in the UAMS Graduate School. “This lack of clear information makes it difficult for healthcare providers to properly counsel patients and shows that more research is needed.”
The most common medical reason women reported for receiving medical cannabis was post-traumatic stress disorder (PTSD), and the most commonly purchased product was plant-based cannabis. The amount of tetrahydrocannabinol, or THC, the primary psychoactive component in cannabis, purchased during pregnancy was substantial across the cohort, including both women who initiated cannabis purchasing during pregnancy and those who continued use from before pregnancy.
The study also identified several patterns of medical cannabis use among pregnant women. Women who purchased medical cannabis during pregnancy were more likely to be older than 30 years, white, insured through Medicaid, and tobacco users.
The analysis showed that higher THC purchasing was more common among women who continued cannabis use throughout pregnancy, while lower THC purchasing was seen among younger women, women with private insurance, women who received prenatal care, and women living in smaller towns or rural areas compared with large metropolitan areas.