ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2023
Acute care related to cannabis use during pregnancy after the legalization of nonmedical cannabis in Ontario.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 24 citations in OpenAlex.
- Evidence on the effect of in-utero cannabis exposure in neonates.Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- Longitudinal Associations Between Cannabis Use during Pregnancy and Child Cognitive, Motor, and Language Development at 2 Years Old.Maternal and child health journal · 2025Article
- Cannabis Use and Misuse Following Recreational Cannabis Legalization.JAMA network open · 2025Article
- Cannabis Use and Trajectories of Depression and Stress Across the Prenatal Period.JAMA network open · 2024Article
- Evaluation of the Association Between Prenatal Cannabis Use and Risk of Developmental Delay.JAACAP open · 2024Article
- Cannabis Use During Early Pregnancy Following Recreational Cannabis Legalization.JAMA health forum · 2024Article
- The impact of recreational cannabinoid legalization on utilization in a pregnant population.Frontiers in public health · 2024Article
- Article
- Outcomes associated with nonmedical cannabis legalization policy in Canada: taking stock at the 5-year mark.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
- TheJournal of psychiatry & neuroscience : JPNArticle
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8 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCannabis use during pregnancy is increasing, but the contribution of cannabis legalization to these trends is unclear. We sought to determine whether health service utilization related to cannabis use during pregnancy increased after the legalization of nonmedical cannabis in October 2018 in Ontario, Canada.
methodsIn this population-based, repeated cross-sectional study, we evaluated changes in the number of pregnant people who received acute care (emergency department visit or admission to hospital) between January 2015 and July 2021 among all people eligible for the province's public health coverage. We used segmented regression to compare changes in the quarterly rate of pregnant people with acute care related to cannabis use (primary outcome) with the quarterly rates of acute care for mental health conditions or for noncannabis substance use (control conditions). We identified risk factors associated with acute care for cannabis use and the risk of adverse neonatal outcomes using multivariable logistic regression models.
resultsThe mean quarterly rate of acute care for cannabis use during pregnancy increased from 11.0 per 100 000 pregnancies before legalization to 20.0 per 100 000 pregnancies after legalization (incidence rate ratio [IRR] 1.82, 95% confidence interval [CI] 1.44-2.31), while acute care for mental health conditions decreased (IRR 0.86, 95% CI 0.78-0.95) and acute care for noncannabis substance use did not change (IRR 1.03, 95% CI 0.91-1.17). Legalization was not associated with an immediate change, but the quarterly change in rates of pregnancies with acute care for cannabis use increased by 1.13 (95% CI 0.46-1.79) per 100 000 pregnancies after legalization. Pregnant people with acute care for cannabis use had greater odds of having received acute care for hyperemesis gravidarum during their pregnancy than those without acute care for cannabis use (30.9% v. 2.5%, adjusted odds ratio [OR] 9.73, 95% CI 8.01-11.82). Pregnancies with acute care for cannabis use had greater odds of newborns being born preterm (16.9% v. 7.2%, adjusted OR 1.93, 95% CI 1.45-2.56) and of requiring care in the neonatal intensive care unit (31.5% v. 13.0%, adjusted OR 1.94 95% CI 1.54-2.44) than those without acute care for cannabis use.
interpretationThe rate of acute care related to cannabis use during pregnancy almost doubled after legalization of nonmedical cannabis, although absolute increases were small. These findings highlight the need to consider interventions to reduce cannabis use during pregnancy in jurisdictions pursuing legalization.
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