Objective:Environmental perturbations such as prenatal cannabis exposure (PCE) during critical periods may lead to disruptions in biological systems that have downstream consequences on behavior and development. Developmental milestones have served as a measure of normative development that allows providers and parents to identify areas for intervention. However, little is known about the direct impacts of PCE on development milestone attainment and whether failures to attain development milestones mediate later disruptions in executive functioning and behavioral disinhibition. Method:Data from the Adolescent Brain Cognitive Development (ABCD) study were used to examine prenatal cannabis effects on development while using a propensity score approach to control for familial and environmental characteristics. Results:PCE was not significantly associated with any delays in gross motor or language attainment; however, after accounting for confounders via propensity score for PCE (pPCE), PCE was significantly associated with delays in 'saying his/her first word' (Odds Ratio = 1.51, 95% Confidence Interval: [1.08, 2.10]). Upon examining the mediating effects, there were no significant total direct or total indirect effects on executive functioning. However, pPCE was associated with behavioral disinhibition and a significant mediation of PCE on behavioral disinhibition via delays in saying his/her first word were observed. Conclusions:This study suggests that delays in saying his/her first word serves as a risk factor for later behavioral disinhibition/externalizing problems. Importantly, the current study didn't examine language development, rather delays in saying his/her first word can provide insight into the possible impacts prenatal cannabis exposure has on developmental milestone attainment.
Objective:Sleep difficulties are a common motive for cannabis use during pregnancy. However, evidence supporting cannabis use as an effective sleep aid is limited, while substantial research demonstrates the efficacy of cognitive behavioral treatments. This study characterized the sleep complaints of adults using cannabis during pregnancy to inform prevention and intervention efforts. Method:Pregnant adults reporting cannabis use (a) in the month prior to or (b) after becoming pregnant were recruited from across the United States between May and August of 2025. Participants completed a cross-sectional research survey, and those who passed all fraudulent responding criteria were included in data analysis. Descriptive statistics, chi-square, and t-tests compared the demographic and clinical characteristics of pregnant adults who did and did not report using cannabis to help their sleep. Results:Of the 210 valid respondents (100% assigned female at birth, 93% cisgender; age M = 29.3 years; 53% White, 38% Black; 58% in second trimester), 185 persisted in cannabis use during pregnancy and 119 reported using "mostly" or "almost always" to help their sleep. Those using cannabis for sleep reported greater insomnia severity, earlier bedtimes, and more wake after sleep onset than those using cannabis for other reasons, but they were less likely to report taking >30 minutes to fall asleep, consistent with expectancies that cannabis would help their sleep. Three out of four using cannabis for sleep (78%) expressed interest in alternative sleep treatments. Conclusions:Sleep is a common reason for cannabis use during pregnancy that appears to be a promising target for prevention and intervention efforts.
Objective:Cannabis is the most commonly used illicit substance during pregnancy. Negative health and social outcomes associated with cannabis use disproportionately affect birthing people of color, particularly Latinas. Latina birthing people face compounding barriers to prenatal care, including discrimination, immigration-related fears, and distrust of healthcare systems rooted in histories of obstetric racism. This study examines the perspectives and experiences of Latina birthing people in California as they navigate prenatal care while using cannabis. Method:We conducted qualitative, semi-structured interviews with 20 Latina birthing people. Eligible participants reported current or previous pregnancy within the last year concurrent with cannabis use, identified as Latina, lived in California, were 21 years or older, and spoke English and/or Spanish. We used constructivist grounded theory methods to analyze the data. Results:We found that Latina birthing people who use cannabis: 1) Perceived their intersectional identities (race/ethnicity, age, partnership status) as potential vulnerabilities to poor prenatal care, particularly around cannabis use disclosure; 2) Sought more supportive clinicians based on these intersectional identities, though financial and insurance barriers prevented them from accessing preferred clinicians; and 3) Proposed solutions to improve their care, such as identifying clinicians who looked like them or adopting a whole-person approach that contextualized their cannabis use within their lived experiences. Conclusions:Discrimination, stigma, and racial profiling of Latina birthing people who use cannabis contribute to unsafe prenatal care environments. Open communication about the motivations and implications of cannabis use is needed to improve prenatal experiences and outcomes for Latinas, who may be using cannabis as a form of self-medication in the context of inadequate care access. Given that Latina birthing people who use cannabis experience discrimination, stigma, and racial profiling in prenatal care settings, it is critical to build structurally competent clinical environments that foster open, nonjudgmental counseling where discussions around cannabis use can occur safely. Systems-level interventions are needed, including clinician training on cannabis use counseling and bias, expanded and diversified clinical workforces, and community-based care options, such as doula integration.
Objective: Perinatal cannabis use is a significant public health concern linked to adverse maternal and neonatal outcomes. Despite growing evidence of prenatal cannabis use (PCU) risks, many individuals use it to manage symptoms such as nausea, anxiety, or pain. The Theory of Planned Behavior (TPB) identifies intentions as key predictors of substance use. While intentions and use patterns have been well studied in non-pregnant populations, research on prenatal intentions for cannabis use is limited. This pilot ecological momentary assessment (EMA) study examines: (a) cannabis use and non-use days in terms of intentions and use; (b) associations between daily intentions and use across prenatal and postpartum; and (c) motives linked to planned versus unplanned use. Method: Pregnant participants (N = 20; Mage = 30.15) reporting current prenatal CU completed two 14-day EMA bursts (in pregnancy and at 6-weeks postpartum) tracking daily CU, motives, and intentions. Planned use days were coded based on morning endorsement of intention to use, followed by reported use; unplanned use days were coded based on no morning intention, followed by reported use. Results: Planned use was most common both in pregnancy and postpartum, followed by planned nonuse, unplanned use, and foregoing plans to use. Intentions strongly predicted daily cannabis use (OR = 5.78, p < .001), with no significant difference between pregnancy and postpartum. Common motives across both planned and unplanned days included relaxation, pain relief, and sleep improvement. Some motives, including appetite increase and anxiety reduction, were more frequent on planned days, while enhancement motives were more common on unplanned days. Conclusions: Findings support TPB’s relevance to perinatal cannabis use, highlighting distinct motives for planned versus unplanned use. Larger samples are needed to expand these insights.
