Sociodemographic Differences in Modes of Cannabis Use Among Pregnant Individuals in Northern California

The potential risks of prenatal cannabis use may vary depending on how cannabis is administered, but little is known about modes of prenatal cannabis use. This study characterized prevalence and sociodemographic correlates of modes of prenatal cannabis use in California. This cross-sectional study included patients with pregnancies between January 1, 2021 and December 31, 2022 in a large healthcare system (3,507 pregnancies [3,454 individuals]) who self-reported prenatal cannabis use and mode of use (smoke, vape, edibles, dabs, and topicals) during universal screening at entrance to prenatal care. Multivariable regression models examined the relationship between sociodemographic characteristics and modes of use. Smoking was the most common mode (71.1%), followed by edibles (32.6%), vaping (22.2%), dabs (9.9%), and topicals (4.6%); 29.9% endorsed multiple modes. Those who used edibles were the least likely to use daily (28.2%), while those who dabbed (54.3%) or used >1 mode (54.3%) were the most likely to use daily. In multivariable models, smoking was generally more common and edibles less common among those who were younger, Black, and living in more deprived neighborhoods, vaping was more common among Hispanic individuals and less common among Black individuals and those living in more deprived neighborhoods, and dabbing was more common among those who were younger and Hispanic. Modes of cannabis use during early pregnancy varied by sociodemographic characteristics. Future research is needed to test whether the risks of adverse outcomes or likelihood of persistent use during pregnancy vary depending on how cannabis is administered during pregnancy. •Smoking and edibles are the most common modes of prenatal cannabis use•29.9% of individuals with cannabis use during early pregnancy used >1 mode•Modes of prenatal cannabis use varied substantially with socio-demographics and use frequency•Continued surveillance can help guide targeted prevention and intervention strategies