Interaction with the justice system and other factors associated with pregnant women’s self-report and continuation of use of marijuana

•Approximately half of pregnant women who have a positive biologic screen for marijuana self-report their use to a healthcare provider.•Approximately one quarter of women who use marijuana will continue to use throughout pregnancy.•Having prior interaction with the justice system does not affect the likelihood that a pregnant woman will self-report her use.•Pregnant women with a positive toxicology test who self-report use are more likely to continue to use throughout pregnancy. Marijuana use in pregnancy is common and self-report of use to healthcare providers is variable. This study evaluates the relationship between prior interaction with the justice system as well as other factors associated with self-report and continuation of use of marijuana in pregnancy. This retrospective cohort study included women with a positive urine toxicology test for marijuana at their initial prenatal visit. Prior interaction with the judicial system was determined by querying a publicly available database. Those who did and did not self-report use were compared using chi square and Fisher’s exact test for analysis of categorical variables and t test for comparison of means. A logistic regression was performed to determine factors related to remaining positive at the time of birth. Of 597 women included in analysis, 308 (51.6%) self-reported use. African American women were more likely to self-report use (p = 0.02). Interaction with the justice system was not statistically predictive of self-report. Of 483 (80.9%) who had birth outcome data available, 117 (24.2%) had positive marijuana tests at the time of delivery. Women who tested positive at birth were older (27.3 v 25, p