# 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 · 2020 · $162,108

## Abstract

PROJECT SUMMARY/ABSTRACT
The COVID-19 pandemic has high potential to lead to broad increases in substance use among pregnant
women (e.g., via increased social isolation and loneliness due to extensive “shelter-in-place” orders,
psychological and financial distress, fear of infection). Further, smoking, vaping and other substance use may
increase risk for COVID-19 and its more serious complications; pregnant women are an ideal population to
study the effects of substance use on COVID-19 risk and illness progression as they have reduced immune
functioning and, in Kaiser Permanente Northern California (KPNC), are routinely screened for substance use
as part of standard prenatal care. The proposed study represents an unparalleled opportunity to efficiently
leverage rich, valid and contemporary prenatal substance use data by self-report and urine toxicology testing
from our existing R01 study (DA047405) in innovative ways. For Aim 1, we take advantage of a unique natural
experiment using interrupted time series analyses to examine whether the COVID-19 pandemic is associated
with broad increases in prenatal substance use overall and among vulnerable subsets of pregnant women
(e.g., those with prenatal depression, low socioeconomic status (SES)) using data from ~200,000 pregnancies
universally screened for prenatal substance from January 2018 to December 2021. For Aim 2, we will conduct
a retrospective and prospective longitudinal cohort study of ~100,000 pregnant women from January 2020 to
December 2021, to examine whether substance use in the year before pregnancy, and during pregnancy, is
associated with increased risk of COVID-19 onset and severity of illness. COVID-19 data will be ascertained
from KPNC’s innovative tracking and surveillance system which includes laboratory confirmed COVID-19
infection, persons under investigation with symptoms who have not yet been tested, symptom severity, medical
complications, and mortality. These data will be efficiently linked to prenatal substance use data ascertained
for the parent grant using the electronic health record with high generalizability and a large sample size. Our
results will provide sorely needed and generalizable data on the impact of this pandemic on rates of prenatal
substance use and the impact of substance use on COVID-19 onset and progression. Results will guide
preventive measures, public health interventions, and health services, and can inform best practices to protect
pregnant women against potential long-term health consequences of this pandemic.

## Key facts

- **NIH application ID:** 10165276
- **Project number:** 3R01DA047405-02S1
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Lyndsay Ammon Avalos
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $162,108
- **Award type:** 3
- **Project period:** 2019-07-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10165276

## Citation

> US National Institutes of Health, RePORTER application 10165276, Maternal Marijuana Use During Pregnancy, Marijuana Legalization, and Adverse Obstetrical and Neonatal Outcomes: A 12-year Cohort Study (3R01DA047405-02S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10165276. Licensed CC0.

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