Uncovering the Hidden Risks of Prenatal Cannabis and E-Cigarette Use

Prenatal e-cigarette and cannabis use are increasing. Though concerning, the risks associated with these emerging exposures are unclear due to methodological limitations of available research. To address these gaps, the Mountain Mama & Baby Study prospectively enrolled a cohort of pregnant women in their first trimester during their initial telehealth visit with a nurse navigator at West Virginia University Medicine obstetric clinics. The study's goals were to: (1) demonstrate the feasibility of our recruitment methodology and the representativeness of the sample; (2) establish first and third trimester exposure rates and describe the epidemiology of prenatal e-cigarette and cannabis use; and (3) explore associations between prenatal e-cigarette and cannabis exposure and adverse maternal-infant outcomes. This report describes the rationale, study design, protocol, and the feasibility and generalizability of recruitment. We enrolled 417 of 920 eligible participants (45.3%; 95% confidence interval: 42.1% to 48.6%), exceeding our 20% benchmark. Enrolled participants and those non-enrolled were similar across most sociodemographic characteristics (e.g., age, race/ethnicity, marital status, rurality, area deprivation). The Mountain Mama & Baby Study will provide clinicians, pregnant women, and public health practitioners with critical information on the potential harms of prenatal e-cigarette and cannabis use, guiding the design of interventions and recommendations.