UAMS Study Finds 3.8% of Pregnant Arkansans Used Cannabis in 2021

Study Design and Sample Size

The UAMS team analyzed data from 1,247 pregnant women enrolled in the Arkansas Pregnancy Risk Assessment Monitoring System (PRAMS) between 2020 and 2021. Researchers focused on self-reported cannabis use during the three months before pregnancy and throughout gestation. This is the first peer-reviewed examination of cannabis use among pregnant Arkansans since the state launched its medical marijuana program in 2019.

Researchers used CDC-validated survey instruments to capture use patterns. The 3.8% prevalence figure aligns with national estimates. It also raises questions about whether medical card holders were included in the count.

Medical vs. Recreational Context

Arkansas permits medical cannabis but not recreational use, creating a regulatory gray area for pregnant patients seeking symptom relief. The state's medical marijuana program doesn't explicitly prohibit pregnant women from obtaining cards, though dispensaries typically counsel against use during pregnancy. Federal agencies including the FDA and CDC recommend against any cannabis use during pregnancy, citing developmental risks.

The study didn't distinguish between medical cardholders and illicit users. That omission limits the policy utility of the findings, since medical patients face different legal and clinical considerations than recreational users.

Clinical Implications and Warnings

Cannabis use during pregnancy has been linked to low birth weight, preterm birth, and neurodevelopmental delays in some observational studies. THC crosses the placental barrier. It concentrates in fetal brain tissue. The American College of Obstetricians and Gynecologists advises against use during pregnancy and lactation.

The 3.8% prevalence matches national trends, but Arkansas's medical-only framework complicates counseling for providers who must balance state-legal access against federal warnings.

UAMS researchers noted that many pregnant women use cannabis to manage nausea, a common first-trimester symptom. No FDA-approved cannabis products exist for morning sickness.

Data Gaps and Methodology Limits

The study relied on self-reported data, which typically underestimates substance use during pregnancy due to social desirability bias and legal concerns. Biological testing would yield higher prevalence figures. The PRAMS survey doesn't capture dosage, frequency, consumption method, or cannabinoid profile—all variables that affect fetal exposure risk.

The 2020-2021 sample predates Arkansas's dispensary expansion in 2022-2023, meaning current use rates may differ. For full background on this story, see the CannIntel topic hub on cannabis use during pregnancy.

What Providers and Policymakers Should Watch

The next phase of research should separate medical cardholders from illicit users and track outcomes longitudinally. Arkansas has issued over 90,000 medical cannabis cards since 2019, but the state doesn't publish demographic breakdowns by pregnancy status. Dispensaries report anecdotal upticks in first-trimester patients, though no sales data exists to confirm the trend.

UAMS plans a follow-up study using birth certificate linkage to assess neonatal outcomes. That dataset will be the first to connect Arkansas medical marijuana registry records with delivery complications, assuming the state grants data access.