Many pregnant drinkers also use cannabis and other substances

This study examines substance use patterns among pregnant individuals, revealing critical information about concurrent alcohol and cannabis use during pregnancy. Using data from 1,426 participants in the HEALthy Brain and Child Development (HBCD) Study, researchers found that 12.7% of pregnant individuals consumed more-than-minimal alcohol, and notably, 37% of these alcohol-consuming pregnancies involved polysubstance use. The most common combination involved alcohol, cannabis, and/or nicotine, highlighting that concurrent substance exposure is substantially more common than previously documented in pregnancy research.

The study identified two distinct patterns of substance use associated with different risk factors: maternal mental health disorders were positively associated with both alcohol-only and alcohol-plus use, suggesting vulnerable populations require targeted intervention. Importantly, higher socioeconomic status (SES) was linked to alcohol-only use, while lower SES was associated with polysubstance use, indicating that substance use during pregnancy crosses socioeconomic boundaries but manifests differently based on economic circumstances. These findings underscore that over one-third of pregnant individuals using alcohol also consumed at least one additional substance, a concerning rate that demands greater clinical attention.

The research underscores the need for comprehensive maternal health screening that accounts for polysubstance use patterns, particularly cannabis-alcohol combinations. The associations with maternal mental health and socioeconomic status provide actionable targets for public health policy, enhanced prenatal screening protocols, and tailored interventions designed to support both maternal wellbeing and healthy child development.