R42 MCH Secondary Data Analysis Research - PROBLEM: Cannabis use during pregnancy is a growing maternal and child health (MCH) issue in the US. At the same time that prenatal cannabis use prevalence has increased, nascent evidence has found that in utero cannabis exposure is linked to adverse neonatal health outcomes (i.e., preterm birth, small for gestational age (SGA), and admittance to the neonatal intensive care unit). Upward ticks in maternal cannabis use in recent years may be a result of the COVID-19 pandemic. Significant disparities exist in prenatal cannabis use across maternal sociodemographic characteristics and social determinants of health (SDOH). Thus, prenatal cannabis use may further exacerbate health disparities in MCH outcomes. Effective clinician-patient communication holds great opportunity to reduce prenatal cannabis use and subsequent outcomes but has yet to be examined at a population-level in the US – a gap this research will fill. GOAL(S) AND OBJECTIVES: To reduce health disparities in MCH outcomes, we will: (1) examine cannabis communication received during prenatal care visits across states and over time, including variations in communication received across maternal sociodemographic characteristics, SDOH, and cannabis policies; (2) examine the association between cannabis communication during prenatal care visits and perinatal health outcomes, including prenatal cannabis use and neonatal health outcomes, and potential moderators of these associations; and (3) examine the impact of the COVID-19 pandemic on maternal cannabis use and maternal health outcomes and cannabis communication received during prenatal care visits We propose the following objectives: PROPOSED DATA SETS AND TARGET POPULATION(S): We will use data from the 2017-2021 Pregnancy Risk Assessment Monitoring System (PRAMS), a population-based surveillance system of the CDC covering approximately 83% of all US births. PRAMS sites follow a standardized data collection protocol that uses birth certificates as the sampling frame to identify women delivering a live-born infant during each surveillance year. Many PRAMS sites oversample low weight births and stratify sampling by maternal race or ethnicity, ensuring a diverse sample. PRODUCTS: We will disseminate our findings at the state and national levels, developing at least 3 peer-reviewed manuscripts and presenting at 2 conferences. We will also include timely methods of dissemination into our dissemination plan (i.e., media interviews, commentaries, meetings with professional organizations). EVALUATION: We will focus on process evaluation for this project and deem our research a success if we meet our proposed objectives and outputs. KEY TERMS: Prenatal, Perinatal, Pregnancy, Prenatal Care, Clinical Practice, Substance Use, COVID-19, Health Disparities
