# Endocannabinoid System Research: Cannabis in Prenatal Care > **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637) > **Publisher:** CED Clinic (https://cedclinic.com) > **Canonical URL:** https://cedclinic.com/prenatal-cannabis-polysubstance-use-risks-research/ > **Published:** 2026-04-15T13:54:35-04:00 | **Last Modified / Clinically Audited:** 2026-09-28T11:01:35-04:00 > **Clinical Summary:** Explore prenatal cannabis polysubstance use and its impact on maternal and child health with current endocannabinoid system research insights. --- #### Clinical Takeaway Prenatal alcohol exposure frequently occurs alongside use of other substances including cannabis, tobacco, and opioids, meaning clinicians should screen for polysubstance use rather than alcohol alone. Identifying concurrent [substance use](https://cedclinic.com/stroke-risk-assessment-substance-use/) patterns during pregnancy allows for more targeted counseling and risk stratification. No amount of alcohol has been established as safe during pregnancy, and co-exposure to additional substances may compound developmental risks for the child. ### #3 Substance use patterns among individuals who consume alcohol during pregnancy: Results from a US multi-site study. **Citation:** Bakhireva Ludmila N et al. *Substance use patterns among individuals who consume alcohol during pregnancy: Results from a US multi-site study.* Drug and alcohol dependence. 2026. PMID: 41797178. **Study type:** Journal Article, Multicenter Study  |  **Topic area:** Pediatrics  |  **CED Score:** 13 Design: 2 Journal: 0 N: 4 Recency: 3 Pop: 3 Human: 1 Risk: 0 **Methodological Considerations:** - Self-reported outcomes — recall and social-desirability bias risk **Abstract:** INTRODUCTION: Prenatal alcohol exposure (PAE) is common and associated with adverse outcomes, yet the impact of concurrent substance use remains poorly understood. Using HEALthy Brain and [Child Development](https://cedclinic.com/rethinking-diagnosis-in-children/) (HBCD) data (n = 1426), we described alcohol use patterns-with and without other substances-and examined factors associated with alcohol use in pregnancy. METHODS: Data were obtained from the HBCD Study public release 1.0, a 27-site longitudinal cohort examining normative development and the effects of four primary substances (alcohol, cannabis, tobacco, and opioids). More-than-minimal PAE was assessed by self-report and ethanol biomarkers. Participants were classified into 3 study groups: a) Alcohol-Only; b) Alcohol-Plus (alcohol with ≥1 other substance); and c) Comparison (alcohol use below the threshold and negative ethanol biomarkers). Correlates of alcohol use were assessed via polychotomous logistic regression contrasting two alcohol-use categories relative to a common reference group. RESULTS: More-than-minimal alcohol use occurred in 12.7% of participants, with 37% of these also using other substances. The most common polysubstance use pattern was a combination of alcohol, cannabis, and/or nicotine, which occurred, in different combinations, among 28% of participants. Maternal [mental health disorders](https://cedclinic.com/cannabinoid-receptor-type-2-schizophrenia/) were positively associated with both Alcohol-Only and Alcohol-Plus use. Higher socioeconomic status (SES) was associated with Alcohol-Only use, whereas lower SES was associated with Alcohol-Plus use. CONCLUSIONS: Over one-third of pregnant individuals who used alcohol also used at least one additional substance. Observed associations with maternal [mental health](https://cedclinic.com/cannabis-psychiatric-research-findings-depression-anxiety/) and SES highlight opportunities for targeted policy, enhanced screening, and tailored interventions to support maternal and child health.  |   |  [View on PubMed ↗](https://pubmed.ncbi.nlm.nih.gov/41797178/)[Full Text ↗](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065066/)[DOI ↗](https://doi.org/10.1016/j.drugalcdep.2026.113101) [https://cedclinic.com/contact/](https://cedclinic.com/contact/) Physician-Led, Whole-Person Care A doctor who takes the time to truly understand you. Personal care that starts with listening and is guided by experience and ingenuity. 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[Read More](https://cedclinic.com/endocannabinoid-system-prenatal-substance-use-research/) [Endocannabinoid System and Pregnancy: Clinical Evidence](https://cedclinic.com/prenatal-alcohol-exposure-polysubstance-use-clinical-evidence/) Clinical evidence on how the endocannabinoid system interacts with pregnancy and substance exposure. [Learn More](https://cedclinic.com/prenatal-alcohol-exposure-polysubstance-use-clinical-evidence/) [Endocannabinoid System Clinical Research: Pregnancy Alcohol Use Study](https://cedclinic.com/prenatal-alcohol-exposure-substance-use-patterns-pregnancy/) A focused study on alcohol use during pregnancy and its clinical implications on the endocannabinoid system. [Explore Study](https://cedclinic.com/prenatal-alcohol-exposure-substance-use-patterns-pregnancy/) Have thoughts on this? 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