Observational Study of Cannabis Use Among Pregnant Women Who Used Nicotine.

Ashford K.; Blair L.; Wiggins A.; Strickland B.; Degrosky D.; Stryd S. · Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2026

**Background & Methods** This descriptive observational study examined cannabis use perceptions and motivations among 81 pregnant women who used nicotine across prenatal clinics in Kentucky (where cannabis was illegal during data collection). Participants were surveyed at each trimester and completed routine clinical urine drug screening alongside self-report measures for cannabis use. **Key Findings** - **Prevalence of use:** 18.5% (n=15) self-reported cannabis use in the past 30 days, while 21% (n=17) tested positive on routine urine drug screening, suggesting potential underreporting via self-report. - **Perceptions of safety:** The majority of participants (83.8%, n=67) believed cannabis use was acceptable during pregnancy, with 61.7% (n=50) reporting it posed no health hazard at all. - **Motivations for use:** Among those self-reporting cannabis use, common reasons included stress reduction (93.3%, n=14), sleep aid (66.7%, n=10), fear reduction (66.7%, n=10), and relief of physical or emotional pain (60%, n=9). **Dosage & Administration** Not reported. **Safety & Adverse Effects** The study did not report specific adverse effects or maternal/fetal outcomes associated with cannabis use. However, the authors emphasize that changing perceptions regarding cannabis acceptability in the prenatal period "place pregnant women and their children at risk of harm," implying potential but unspecified harms. **Evidence Quality** This study has significant limitations inherent to its design. As a descriptive observational study without a control group or outcome tracking, it cannot establish causality or determine adverse effects. The sample is small (N=81) and geographically limited to Kentucky. The discrepancy between self-reported use (18.5%) and positive urine screens (21%) suggests potential under-reporting bias. The study was conducted in a jurisdiction where cannabis was illegal, which may have influenced disclosure. Most critically, the study characterizes perceptions rather than establishing evidence-based risk; the authors' conclusion about harm risk is not directly supported by their findings. This represents low-quality evidence suitable for hypothesis generation but insufficient for clinical recommendations.

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