• Vanessa L Short, Dennis J Hand, Meghan Gannon, and Diane J Abatemarco.
• Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Pennsylvania. Electronic address: vanessa.short@jefferson.edu.
• Am J Prev Med. 2020 Oct 1; 59 (4): 555-561.

IntroductionGiven the increase of marijuana use among U.S. women, higher rates of unintended pregnancies among women who use marijuana, and potential consequences of maternal use, there is a need to identify factors associated with marijuana use in the period leading up to pregnancy. This study aims to provide estimates of preconception marijuana use and describe associations between preconception marijuana use and maternal characteristics among a population-based sample of recently delivered women in the U.S.MethodsThis was an analysis of 2016 Pregnancy Risk Assessment Monitoring System data from 6 states (Louisiana, Maine, New Mexico, Vermont, Wisconsin, and Wyoming). Characteristics were compared between respondents who did and did not report marijuana use using chi-square tests and logistic regression models. Statistical analysis was performed in 2019 and 2020.ResultsApproximately 8% of respondents reported that they had used marijuana in the month before pregnancy. After controlling for a number of factors, marital status, education level, parity, and living in a state with medical or recreational marijuana legalization or decriminalization remained independently associated with marijuana use. Those who reported marijuana use were 3-5 times more likely to also report symptoms of depression and tobacco and alcohol use before or during pregnancy than respondents who did not report marijuana use.ConclusionsReproductive-aged women who are intending pregnancy or likely to experience an unintended pregnancy should be asked about and encouraged to refrain from marijuana use, especially given the strong association with depressive symptomology and concurrent use of other substances, including tobacco.Copyright © 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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