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More pregnant women used cannabis in the early stages of pregnancy during the COVID-19 pandemic than prior to it, researchers found.

Based on urine tests performed at about 8 weeks' gestation, the standardized rate of prenatal cannabis use was 8.14% (95% CI 7.85-8.43%) for pregnancies from April to December 2020 compared with 6.75% (95% CI 6.55-6.95%) for those from January 2019 to March 2020, reported Kelly Young-Wolff, PhD, MPH, of Kaiser Permanente Northern California in Oakland, and colleagues.

This amounted to a 25% (95% CI 12-40%) increase in prenatal cannabis use compared with the 15 months prior to the pandemic, the authors wrote in a .

While the study did not determine why pregnant women were using more cannabis, Young-Wolff and colleagues noted that prior research found women are more likely to use cannabis in pregnancy if they are depressed, anxious, or have experienced trauma. Therefore, women may have been "self-medicating" during the pandemic, they said.

"The stay-at-home mandates, concerns about getting COVID-19, economic challenges, increased child care burden, and other difficult aspects of the pandemic could contribute to pregnant women feeling more stressed and depressed," Young-Wolff said in a statement.

The authors noted that cannabis retailers were considered an "essential business" and thus remained open during the lockdowns in California. They said that the study results were consistent with the rise in total cannabis sales seen in California during the pandemic.

They examined data from about 100,000 pregnancies; women were screened for prenatal cannabis use via urine toxicology from Jan. 1, 2019 to Dec. 31, 2020.

Overall, mean age was 31 among the women studied; 34% were non-Hispanic white, 28% were Hispanic, and 26% were Asian or Pacific Islander.

Cannabis use rates prior to and during the pandemic were stable, with no significant month-to-month trends, the authors noted.

While women may be using cannabis to alleviate nausea or mood problems, more clinicians need to inform their patients that cannabis use during pregnancy is not a "healthy choice," said co-author Deborah Ansley, MD, also of Kaiser Permanente, in a statement.

"Clinicians -- and people who work in cannabis dispensaries -- need to help educate women that during pregnancy they should abstain from any type of cannabis use because of potential health risks to their babies," Ansley added.

The data did not specify which cannabis products were used, or the concentrations of CBD or THC in these products, which were limitations. These results only reflect early pregnancy, and cannot provide insight on continued use as pregnancy progresses, the authors noted.

"As the pandemic continues it will be important to identify subgroups of women who are most likely to use cannabis during pregnancy, so we can provide more targeted interventions," said co-author Lyndsay Avalos, PhD, MPH, also of Kaiser Permanente, in a statement.

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