Boston, MA: Patients selected to undergo marijuana-specific drug screening during the labor and delivery process are disproportionately Hispanic or African American and they are also likely to be on subsidized health insurance plans, according to data published in the journal Hospital Pediatrics.
Researchers affiliated with Harvard Medical School assessed characteristics of 1,924 patients who underwent peripartum toxicology testing between 2016 and 2020 at five birthing hospitals in Massachusetts.
Consistent with prior studies, those singled out for testing were disproportionately Black or Hispanic and many were publicly insured. Specifically, Hispanic patients were twice as likely to be mandated to undergo testing and Black patients were four times as likely to be ordered to do so. Those on public health care plans were more than twice as likely to be tested for past cannabis exposure.
However, doctors seldom took any follow up action or made changes to patients’ clinical management after they tested positive for cannabis.
The study’s authors concluded, “Toxicology testing of patients for a sole indication of cannabis use, without other risk factors, may be of limited utility in elucidating other substance use and may exacerbate existing disparities in perinatal outcomes.”
Data assessing the relationship between in utero cannabis exposure and various neonatal outcomes, such as birth weight, is inconsistent. However, longitudinal data indicates that cannabis exposure is rarely independently linked with adverse neurodevelopmental consequences, finding, “Although there is a theoretical potential for cannabis to interfere with neurodevelopment, human data drawn from four prospective cohorts have not identified any long-term or long lasting meaningful differences between children exposed in utero to cannabis and those not.”
Nonetheless, in some states, such as in Oklahoma and Alabama, mothers have been arrested and criminally prosecuted for the use of cannabis during their pregnancy. In total, 24 states and the District of Columbia consider substance use during pregnancy to be child abuse under civil child-welfare statutes, and three consider it grounds for civil commitment, according to data provided by the Guttmacher Policy Review.
Full text of the study, “Limited utility of toxicology testing at delivery for perinatal cannabis use,” appears in Hospital Pediatrics. Additional information is available from the NORML Fact Sheet, ‘Maternal Marijuana use and Childhood Outcomes.’