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. 2017 Dec 26;318(24):2490-2491.
doi: 10.1001/jama.2017.17225.

Trends in Self-reported and Biochemically Tested Marijuana Use Among Pregnant Females in California From 2009-2016

Kelly C Young-Wolff  1 , Lue-Yen Tucker  1 , Stacey Alexeeff  1 , Mary Anne Armstrong  1 , Amy Conway  2 , Constance Weisner  3 , Nancy Goler  4
Affiliations

Trends in Self-reported and Biochemically Tested Marijuana Use Among Pregnant Females in California From 2009-2016

Kelly C Young-Wolff et al. JAMA. .
No abstract available

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Conflict of interest statement

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Figures

Figure 1
Figure 1. Adjusted Prevalence of Marijuana Use Among 279 457 Pregnant Females in KPNC by Screening Type, 2009–2016
KPNC indicates Kaiser Permanente Northern California. Error bars indicate 95% CIs of the adjusted prevalences. Poisson regression models controlled for age group, race/ethnicity, and median neighborhood household income (extracted from the electronic health record). The self-reported use questionnaire and toxicology screening were part of standard prenatal care (at approximately 8 weeks’ gestation; 84%of females completed both screenings during their first trimester). For toxicology tests, 58%were completed at the same visit as the self-reported use questionnaire, 87%were completed within 14 days of completing the questionnaire, and 100% were completed within 8 weeks of completing the questionnaire. All toxicology tests were confirmed with a confirmatory laboratory test. Among pregnant females with a positive test result for prenatal marijuana use, 15.9% were positive on self-report only, 54.9%were positive on toxicology only, and 29.2%were positive on both self-report and toxicology. The sample of females included in the study was generally representative of the population of all pregnant females. There were only small differences in the demographic characteristics of females who were included vs excluded (due to missing data on prenatal marijuana use), indicating minimal to no selection bias. The median sample size across years was 34 322 (range, 32 813–38 919).
Figure 2
Figure 2. Adjusted Prevalence of Marijuana Use Among 279 457 Pregnant Females in KPNC by Age, 2009–2016
KPNC indicates Kaiser Permanente Northern California. Results were based on positive self-report or positive toxicology screening. Error bars indicate 95%CIs of the adjusted prevalences. Age groups included younger than 18 years (n = 3813; 1.4%); 18 to 24 years (n = 44 112; 15.8%); 25 to 34 years (n = 172 278; 61.6%); and older than 34 years (n = 59 254; 21.2%). Poisson regression models by age group controlled for race/ethnicity and median neighborhood household income (extracted from the electronic health record). The self-reported use questionnaire and toxicology screening were part of standard prenatal care (at approximately 8 weeks’ gestation; 84%of females completed both screenings during their first trimester). For toxicology tests, 58%were completed at the same visit as the self-reported use questionnaire, 87%were completed within 14 days of completing the questionnaire, and 100% were completed within 8 weeks of completing the questionnaire. All toxicology tests were confirmed with a confirmatory laboratory test. Among pregnant females with a positive test result for prenatal marijuana use, 15.9%were positive on self-report only, 54.9% were positive on toxicology only, and 29.2%were positive on both self-report and toxicology. The sample of females included in the study was generally representative of the population of all pregnant females. There were only small differences in the demographic characteristics of females who were included vs excluded (due to missing data on prenatal marijuana use), indicating minimal to no selection bias. The median (range) sample size for each age group was 443 (236–779) for less than 18 years; 5485 (5221–5956) for 18 to 24 years; 21 258 (20 002–24 347) for 25 to 34 years; and 7236 (6532–8848) for more than 34 years.
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