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. 2019 Feb;110(1):76-84.
doi: 10.17269/s41997-018-0148-0. Epub 2018 Nov 1.

Trends and correlates of cannabis use in pregnancy: a population-based study in Ontario, Canada from 2012 to 2017

Daniel J Corsi  1   2   3 , Helen Hsu  4 , Deborah Weiss  5   6 , Deshayne B Fell  5   7 , Mark Walker  8   9
Affiliations

Trends and correlates of cannabis use in pregnancy: a population-based study in Ontario, Canada from 2012 to 2017

Daniel J Corsi et al. Can J Public Health. 2019 Feb.

Abstract
in English, French

Objective: Forthcoming legislative changes will legalize and make cannabis widely available in Canada. We conducted an analysis of Ontario's birth registry to determine recent trends and correlates of cannabis use in pregnancy.

Methods: We conducted a population-based retrospective cohort study assembled from the Better Outcomes Registry & Network (BORN) Ontario database, covering live births and stillbirths in Ontario between April 2012 and December 2017. Trends in self-reported cannabis use in pregnancy were analyzed according to maternal age and area-level socio-economic status (SES) using log binomial regression analysis.

Results: A total of 10,731 women reported cannabis use in pregnancy. Prevalence increased from 1.2% in 2012 to 1.8% in 2017 (p-trend, < 0.001), equivalent to a relative increase of 61% (relative risk [RR] 1.61, 95% confidence interval [CI] 1.51 to 1.72). The crude prevalence of cannabis use in pregnancy among women aged 15 to 24 years and in the lowest two area-level income quintiles was 6.7%, compared to 0.3% among women aged 35 years and over in the highest three income quintiles (RR 24.59, 95% CI 21.98 to 27.52). A majority (52.0%) of cannabis users were aged 15-24 years and 54.7% of users were in the lowest two income quintiles.

Conclusion: Cannabis use in pregnancy has increased since 2012 in Ontario and was reported in about 2% of pregnancies in 2017. Increases were predominately among women of younger ages and those of lower SES, and these groups account for half of users. Promoting cannabis cessation in pregnancy could lead to improved perinatal and later childhood outcomes and reduce health inequalities.

Objectif: Des modifications législatives prochaines légaliseront le cannabis et en généraliseront la disponibilité au Canada. Nous avons analysé le registre des naissances de l’Ontario pour en dégager les tendances récentes et les corrélats de la consommation de cannabis durant la grossesse.

Méthode: Nous avons mené une étude de cohorte populationnelle rétrospective à partir des données du Registre et Réseau des Bons Résultats dès la naissance (BORN) de l’Ontario, qui couvre les naissances d’enfants vivants et les mortinaissances enregistrées entre avril 2012 et décembre 2017 en Ontario. Nous avons analysé les tendances de la consommation autodéclarée de cannabis durant la grossesse selon l’âge maternel et le statut socioéconomique régional par régression log-binomiale.

Résultats: En tout, 10,731 femmes ont dit avoir consommé du cannabis durant la grossesse. La prévalence est passée de 1,2 % en 2012 à 1,8 % en 2017 (tendance p < 0,001), ce qui représente une hausse relative de 61 % (risque relatif [RR] 1,61, intervalle de confiance de 95% [IC] 1,51 à 1,72). La prévalence brute de la consommation de cannabis durant la grossesse chez les femmes de 15 à 24 ans dans les deux quintiles de revenu régionaux inférieurs était de 6,7 %, contre 0,3 % chez les femmes de 35 ans et plus dans les trois quintiles de revenu supérieurs (RR 24,59, IC de 95% 21,98 à 27,52). La majorité (52,0 %) des consommatrices de cannabis avait entre 15 et 24 ans, et 54,7 % des consommatrices appartenaient aux deux quintiles de revenu inférieurs.

Conclusion: La consommation de cannabis durant la grossesse a augmenté depuis 2012 en Ontario et a été déclarée dans environ 2 % des grossesses en 2017. Les augmentations ont été constatées principalement chez les jeunes femmes et les femmes de faible statut socioéconomique; ces groupes représentent la moitié des consommatrices. Promouvoir l’arrêt du cannabis durant la grossesse pourrait donc améliorer les résultats périnatals et au cours de l’enfance et réduire les inégalités de santé.

Keywords: Canada; Cannabis; Epidemiology; Marijuana; Pregnancy; Time trends; Women.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Self-reported cannabis use in pregnancy in Ontario, by (a) age (p-trend < 0.001 in four age groups) and (b) area-level income (p-trend < 0.001 in two income groups), 2012–2017
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