Document text
Principal Investigator: Kelly Corinne Young-Wolff
Organization: KAISER FOUNDATION RESEARCH INSTITUTE
Fiscal Year: 2024
Award: $659,404
Funding agency: National Institute on Drug Abuse
PROJECT SUMMARY/ABSTRACT
Importance of the proposed research. Prenatal cannabis use is increasingly common and could have
largescale negative impacts on maternal and fetal health. Legalization of cannabis has led to the proliferation
of new cannabis products with various modes of administration (e.g., vaping, edibles, dabbing blunts) that
differ by THC potency and secondary exposures (e.g., nicotine, chemicals from vaping). Yet, we know little
about how women use cannabis pre- and during pregnancy, whether modes vary with socio-demographics or
local cannabis policies, or how modes relate to cannabis use frequency, cannabis use disorder (CUD),
polysubstance use, quitting use in pregnancy, or adverse health outcomes. To fill this important gap in the
literature, we will conduct an innovative mixed-methods study of ~310,000 racially and ethnically diverse
pregnancies within Kaiser Permanente Northern CA (KPNC) from 2021 to 2026, where patients are universally
screened for substance use as part of standard prenatal care via self-report and urine toxicology testing. Using
rich electronic health record data and cannabis retailer and policy data, our study will examine socio-
demographic and policy correlates of modes of use pre- and during pregnancy and test how modes relate to
the risk of daily use, CUD, polysubstance use, substance use disorders (SUD), quitting pre- or during
pregnancy, addiction treatment, and cannabis-related psychiatric and medical outcomes. With a focus on
disparities, we will also examine differences in key associations by socio-demographic factors and test whether
socio-demographic differences in continued cannabis use during pregnancy are mediated by differences in
modes of administration. To gain further clinical insight and guide next steps, we will conduct interviews with
pregnant women who used cannabis before and/or during pregnancy to understand factors influencing mode
choice, perceived benefits/harms of different modes, changes in modes during pregnancy, and experiences
with quitting. Findings will have immediate public health and clinical implications, providing critical information
about the diverse ways in which women administer cannabis that could shift research and clinical practice
paradigms. Results will also provide important data on whether local regulatory practices (e.g., cannabis
retailer density, restrictiveness of local policies, warnings on prenatal use) are associated with variation in
patterns of modes of cannabis use, informing the development of future regulations throughout the US. Finally,
this unique study cohort will be a rich resource for future research on the impact of different modes of cannabis
administration on fetal and neonatal outcomes.
Terms: <0-11 years old><1st trimester><9-ene-Tetrahydrocannabinol><Address><Age><Anemia><Anxiety><Area><Asthma><Behavior><Bronchial Asthma><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><California><Cannabis><Cannabis Smoking><Cannabis law><Cannabis policy><Cannabis retail><Chemicals><Child><Child Youth><Children (0-21)><Clinical><Cohort Studies><Concurrent Studies><D9-tetrahydrocannabinol><Data><Delta-9-Tetrahydrocannabinol><Development><Diabetes Mellitus><Disparities><Disparity><Early Placental Phase><Electronic Health Record><Exposure to><Fetal health><First Pregnancy Trimester><First Trimester><Frequencies><Future><Gestation><Guidelines><Harm Minimization><Harm Reduction><Health><Hispanic Females><Hispanic Women><Home><Hypertension><Integrated Health Care Systems><Intervention><Intervention Strategies><Interview><Knowledge><Legal><Literature><Maps><Marijuana Smoking><Maternal Health><Maternal cannabis use><Mediating><Medical><Mental Depression><Methods><Moods><Mothers><NIDA><National Institute of Drug Abuse><National Institute on Drug Abuse><Nausea><Nicotine><Outcome><Pain><Painful><Patient Self-Report><Patients><Pattern><Policies><Population Heterogeneity><Pregnancy><Pregnant Women><Premature Birth><Prematurely delivering><Prenatal care><Preterm Birth><Prevention><Proliferating><Public Health><Regulation><Reporting><Research><Research Design><Research Resources><Resources><Risk><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Self-Report><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Smoke><Smoking><Study Type><Subgroup><Substance Use Disorder><Symptoms><THC co-use><THC use><Testing><Tetrahydrocannabinol><Tetrahydrocannabinol co-use><Tetrahydrocannabinol use><Toxicology><Urine><Variant><Variation><Vascular Hypertensive Disease><Vascular Hypertensive Disorder><Waxes><Woman><addiction><addictive disorder><ages><black female><black women><cannabis administration><cannabis legalization><cannabis market><cannabis marketplace><cannabis regulation><cannabis use><cannabis use disorder><cannabis use during pregnancy><cannabis use in pregnancy><cannabis use law><cannabis use policy><clinical practice><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><delta(1)-THC><delta(1)-Tetrahydrocannabinol><delta(9)-THC><delta(9)-Tetrahydrocannabinol><density><depression><developmental><diabetes><diverse populations><early pregnancy><electronic health care record><electronic health medical record><electronic health plan record><electronic health registry><electronic medical health record><ethnic diversity><ethnically diverse><expectant mother><expecting mother><experience><fetal><heterogeneous population><high blood pressure><homes><hyperpiesia><hyperpiesis><hypertensive disease><hypertensive disorder><innovate><innovation><innovative><insight><integrated health system><integrated healthcare systems><integrated system of care><interventional strategy><kids><legal marijuana><legalized cannabis><legalized marijuana><low SES><low socio-economic position><low socio-economic status><low socioeconomic position><low socioeconomic status><marijuana law><marijuana legalization><marijuana policy><marijuana retail><marijuana use><marijuana use and disorder><marijuana use disorder><marijuana use during pregnancy><marijuana use in pregnancy><maternal marijuana use><multiple substance use><multisubstance use><neonatal outcome><non-smoking><nonsmoking><poly substance use><polysubstance use><population diversity><pregnancy care><pregnant mothers><premature childbirth><premature delivery><prenatal><prenatal appointment><prenatal cannabis use><prenatal checkup><prenatal marijuana use><prenatal screening><prenatal testing><prenatal visit><prepregnancy><preterm delivery><racial diversity><racially diverse><reproductive><screening program><sell cannabis><sell marijuana><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><socio-demographic factors><socio-demographics><sociodemographic factors><sociodemographics><study design><substance use><substance use and disorder><substance using><unborn><vaping><young woman><youngster><Δ(1)-THC><Δ(1)-tetrahydrocannabinol><Δ(9)-THC><Δ(9)-tetrahydrocannabinol><Δ-9-tetrahydrocannabinol><Δ9-tetrahydrocannabinol>