Legalization of Nonmedical Cannabis Tied to More Acute Care Visits During Pregnancy

Rate of acute care related to cannabis use during pregnancy increased from 11.0 to 20.0 per 100,000 pregnancies from before versus after legalization

By Lori Solomon HealthDay Reporter

WEDNESDAY, May 24, 2023 (HealthDay News) — While absolute numbers are small, the rate of acute care related to cannabis use during pregnancy almost doubled after legalization of nonmedical cannabis in Canada, according to a study published online May 23 in CMAJ, the journal of the Canadian Medical Association.

Daniel Thomas Myran, M.D., from the University of Ottawa in Canada, and colleagues assessed whether health service utilization related to cannabis use during pregnancy increased after the legalization of nonmedical cannabis in October 2018 in Ontario, Canada. The analysis included acute care episodes (emergency department visit or admission to hospital) between January 2015 and July 2021.

The researchers found that the 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), while acute care for mental health conditions decreased (IRR, 0.86) and acute care for noncannabis substance use remained stable. Compared with pregnant people without acute care for cannabis use, those with acute care for cannabis use had greater odds of having received acute care for hyperemesis gravidarum during their pregnancy (30.9 versus 2.5 percent; adjusted odds ratio [aOR], 9.73). Furthermore, there were greater odds of newborns being born preterm (16.9 versus 7.2 percent; aOR, 1.93) and requiring care in the neonatal intensive care unit (31.5 versus 13.0 percent; aOR, 1.94) for pregnancies with acute care for cannabis use versus those without acute care for cannabis use.

“Our findings highlight the importance of universal screening and suggest that pregnant people with a history of substance use, mental health conditions, or severe morning sickness may benefit from repeated screening and counselling during pregnancy, without stigma,” the authors write.