Cannabis-Related Treatment Outcomes Among Pregnant Women Before and During the COVID-19 Pandemic: A Disparity Analysis Using a Nationally Representative Sample

Cannabis use among pregnant people in the United States has rapidly increased over the past two decades with implications for fetal neonatal and neurodevelopmental outcomes. Most cannabis-related research among pregnant women has focused on factors associated with use and treatment admissions. Thus less is known regarding cannabis-related treatment outcomes in this population. We will address this significant gap in the literature by exploring disparities in cannabis-related treatment outcomes for pregnant women including the influence of state-level cannabis policies and policies on substance use during pregnancy. Additionally this will be the first study to examine the impact the COVID-19 pandemic on treatment outcomes among pregnant women. The project is highly aligned with the following Maternal and Child Health Bureau (MCHB) Strategic Plan Goals: MCHB Goal 1: Improve the health system for mothers and children; MCHB Goal 2: Promote the health and well-being of mothers; and MCHB Goal 5: Increase evidence for MCH practice. It also directly addresses Healthy People 2030 maternal infant & child health (MICH) and substance use disorder (SUD) objectives: MICH-11: Increase abstinence from illicit drugs among pregnant women; SU-01: Increase the proportion of people with a substance use disorder who got treatment in the past year; SU-14: Reduce the proportion of people who had cannabis use disorder in the past year. Goal(s) and Objectives: The goal of this study is to generate evidence that will inform the development and evaluation of strategies to promote equitable cannabis-related treatment outcomes for all pregnant women admitted to a substance use treatment facility. Specifically the study will: 1. Assess disparities in cannabis-related treatment outcomes (treatment completion and length of stay) among pregnant women admitted to a residential or outpatient treatment facility. 2. Examine the impact of the COVID-19 pandemic on cannabis-related treatment outcomes among pregnant women admitted to a residential or outpatient treatment facility. Proposed Data Sets and Target Populations: The study will use the Treatment Episode Data Set-Discharge (TEDS-D) which includes annual data on discharges from publicly funded substance use treatment programs. The dataset is considered generally representative of a national sample. The sample will be comprised of pregnant women whose admission involved cannabis use (n = 112 215) between 2015 and 2020.