Two new federally funded reports published in the Journal of the American Medical Association (JAMA) may help allay at least some concerns around prenatal exposure to marijuana. One study found that cannabis use during early pregnancy was not associated with child autism, while the other found no association with increased risk for early childhood developmental delays.
Both papers were published on Friday in the journal JAMA Network Open and looked at outcomes of pregnancies where maternal marijuana use was either self-reported or identified through a positive urine test for THC at the entrance to prenatal care, about two months into gestation.
The autism spectrum disorder (ASD) analysis included data from 178,948 pregnancies born to 146,296 unique individuals between 2011 and 2019, while the early development research used data from 119,976 pregnancies born to 106,240 people between early 2015 and late 2019. Children were screened at various points on autism and developmental measures.
“In this study, maternal prenatal cannabis use was not associated with childhood ASD after adjusting for potential cofounders,” says the autism study, “including sociodemographic characteristics, other noncannabis substance use and maternal comorbidities.”
“We found no association between prenatal cannabis use in early pregnancy and child [autism spectrum disorder].”
Similarly, the investigation into marijuana and childhood development found that “maternal cannabis use during early pregnancy was not associated with speech and language disorders, global delay, or motor delay.”
Both studies, which were funded by the National Institute on Drug Abuse, caution that their findings don’t mean that using marijuana during pregnancy is safe, especially when use is frequent or heavy.
Authors note, for example, that while the autism findings suggested that cannabis use during pregnancy isn’t associated with autism in children overall, “there may be an association with higher frequency use, highlighting the need for more research.”
One exception to the childhood development study, meanwhile, is that researchers observed a “modest inverse association between speech and language disorders when defining cannabis use based only on the urine toxicology results.” No such association was seen in the self-reported use data.
In line with guidance from the American College of Obstetrics and Gynecology and the American Academy of Pediatrics, the studies also advise that “pregnant individuals should discontinue cannabis use.”
Authors further recommend that “pregnant individuals and those considering pregnancy should be educated on the known adverse fetal and neonatal health-effects of maternal prenatal cannabis use.”
Teams behind both studies were led by researchers at Kaiser Permanente Northern California, where the health data was drawn from. Authors said they believe the research to represent “the largest number of pregnancies with maternal prenatal cannabis use studied.”
“Maternal cannabis use in early pregnancy was not associated with an increased risk of child early developmental delays.”
Authors said their findings align with the bulk of research into childhood development outcomes following maternal marijuana use, although they noted that some past research had suggested a negative association. Similarly, they noted that their findings contrast with a 2023 study suggesting a connection with autism.
As scientists work to wrap their arms around the possible risks of maternal marijuana use, law enforcement officials in some jurisdictions are already targeting pregnant individuals for arrest and prosecution as a result of cannabis or other drug use.
A recent report from a reproductive rights organization, for instance, found that pregnancy-related prosecutions are at an all-time high in the wake of the 2022 Supreme Court decision that ended the nationwide right to abortion. And by far the most common criminal allegation facing pregnant people is that they used marijuana or other drugs during their pregnancies.
The report, from the group Pregnancy Justice, identified 210 criminal cases filed against people for conduct associated with pregnancy, pregnancy loss or birth during the first year after high court’s Dobbs ruling, which overturned Roe v. Wade. Of those, 203 cases—nearly 97 percent—involved allegations of substance use during pregnancy. Drug use was the sole allegation in 133 of those cases.
Marijuana was the second most commonly cited drug in the court charges, following methamphetamines, with allegations of cannabis use appearing in 86 of the 210 cases. In more than a third of those cases, THC use was the only allegation underlying the criminal charges.
“It is significant that, in eighty-six cases, the police or prosecution alleged that the defendant took some form of THC during her pregnancy, and in thirty-one of those eighty-six cases, the only allegation supporting prosecution was THC use,” the new report says. “Even more startling, in five of those cases, the court file included statements that the defendant had a medical marijuana card, indicating that she was being charged with taking legally prescribed medication.”
Notably, rates of prosecution varied strikingly across the country, according to the report. Alabama, for example, was responsible for nearly half of the prosecutions, at 104, followed by Oklahoma at 68 and South Carolina at 10.
The majority of defendants charged in pregnancy-related cases were also low income, it noted.
In Oklahoma, local news in 2022 began reporting that prosecutors there were targeting pregnant women for using medical marijuana, resulting in felony child neglect charges being filed against 26 mothers. The crime can carry up to a life prison in Oklahoma.
Then in July a state court ruled that people cannot be prosecuted for child neglect for legally using medical marijuana while pregnant.
In 2022 an Alabama Senate committee approved a bill to force women who want medical marijuana to provide a negative pregnancy test.
Early last year, meanwhile, National Institute on Drug Abuse (NIDA) Director Nora Volkow blasted the criminalization of drug use by pregnant people and new parents, arguing that the resulting stigmatization is harming families and contributing to the overdose crisis.
She said that families need “support, not criminalization.”
“People seeking treatment for addictions face additional obstacles, especially if they have children,” she wrote. “Only a small minority of treatment facilities provide child care, creating yet another obstacle on top of securing transportation, housing, food, and other necessities, all of which can be more difficult for people who are also supporting children. The barriers get even higher for pregnant people.”
Volkow also noted what was at the time a demonstrable increase in overdose deaths among people during and immediately after pregnancy, which became the leading cause of death during or shortly after pregnancy, ranking higher than “excessive bleeding, cardiovascular conditions, or other well-known complications of pregnancy.”
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