# Maternal Marijuana Use During Pregnancy, Marijuana Legalization, and Adverse Obstetrical and Neonatal Outcomes: A 12-year Cohort Study

> **NIH NIH R01** · KAISER FOUNDATION RESEARCH INSTITUTE · 2021 · $809,599

## Abstract

PROJECT SUMMARY/ABSTRACT
Prenatal marijuana use is increasingly recognized as an important public health problem that could have a
large scale negative impact on maternal, fetal and neonatal health. We propose a retrospective and
prospective longitudinal cohort study of over 400,000 pregnancies screened for prenatal marijuana use based
on gold standard self-reported and urine toxicology data from 2009 to 2020, leveraging Kaiser Permanente
Northern California’s universal prenatal substance use screening program that is part of standard prenatal
care. We will assess associations between maternal marijuana use during pregnancy and key maternal, fetal
and neonatal outcomes, controlling for potential confounders (e.g., tobacco use, alcohol and other drug
exposure, income) and comparing exposure across trimesters. These analyses also take advantage of a
unique natural experiment and will examine whether California state marijuana legalization in 2018 and local
regulatory practices (e.g., retailer bans, prominent warnings on marijuana use during pregnancy) are
associated with variation in marijuana use during pregnancy. With high generalizability and a sample size
unmatched by any other study on this topic, results from each aim have direct implications for the care of
pregnant women while providing novel insight to drive future epidemiological and clinical trial-based
intervention studies. Aims 1 and 2 will provide generalizable and comprehensive data to understand the health
impact of prenatal marijuana use on mothers and their babies. Aim 3 will allow us to identify changing trends in
prenatal marijuana use following marijuana legalization and will inform clinicians, researchers, and policy
makers of the future scope of the problem. Finally, the study cohort will be a valuable resource for future
research on the long-term impact of prenatal marijuana use on maternal and children’s well-being.

## Key facts

- **NIH application ID:** 10149979
- **Project number:** 5R01DA047405-03
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Lyndsay Ammon Avalos
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $809,599
- **Award type:** 5
- **Project period:** 2019-07-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10149979

## Citation

> US National Institutes of Health, RePORTER application 10149979, Maternal Marijuana Use During Pregnancy, Marijuana Legalization, and Adverse Obstetrical and Neonatal Outcomes: A 12-year Cohort Study (5R01DA047405-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10149979. Licensed CC0.

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