ArticlePaediatric and perinatal epidemiology2026
A Prospective Study of Preconception and Early Pregnancy Cannabis Use and Birth Outcomes.
Article in Paediatric and perinatal epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCannabis use among reproductive-aged individuals is common, yet there are gaps in our understanding of the effect of cannabis use on adverse birth outcomes.
objectiveTo determine the extent to which female and male preconception cannabis use and female early pregnancy cannabis use are associated with the incidence of preterm birth (PTB), small-for-gestational-age birth (SGA), and large-for-gestational-age (LGA) birth.
methodsWe analysed data from Pregnancy Study Online, an internet-based preconception cohort study of couples trying to conceive. Eligible participants were aged 21-45 years (female) and ≥ 21 years (male) and residents of the United States or Canada. We followed 6838 couples who conceived between June 2013 and September 2024. Both partners completed preconception baseline questionnaires; female participants completed preconception follow-up questionnaires every 8 weeks, at early (< 12 weeks) and late pregnancy (~32 weeks), and at 6 months postpartum. Participants self-reported cannabis use during preconception (female and male) and early pregnancy (female only). We ascertained birthweight and gestational age from birth certificates and questionnaires and defined PTB (delivery < 37 gestational weeks) and SGA and LGA (< 10th and > 90th percentiles of birthweight, respectively, for gestational age and sex). We fit Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI), adjusting for potential confounders.
resultsPreconception cannabis use was not appreciably associated with PTB (≥ 1 per week vs. non-use: HR 1.06, 95% CI 0.71, 1.57 for females and HR 1.41, 95% CI 0.73, 2.75 for males). Higher frequency of female cannabis use in early pregnancy was associated with an increased incidence of PTB, although results were imprecise (≥ 1 per week vs. non-use: HR 1.87, 95% CI 1.06, 3.29; < 1/week vs. non-use: HR 0.85, 95% CI 0.36, 2.02). Cannabis use in either partner was not associated with the incidence of SGA or LGA.
conclusionsOur results support the existing evidence that cannabis use during early pregnancy is a risk factor for PTB.
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