Validity of Self-Reported Cannabis Use Based on Urine Toxicology Measures in a Population-Based Pregnancy Cohort in Michigan

Résumé fourni par la source

Prenatal cannabis use may be underreported due to social stigma and fear of legal repercussions. The study assesses the validity of self-reported prenatal cannabis use versus urine toxicology measures and determines correlates of non-disclosure. Data are from a statewide population-based pregnancy cohort (MARCH- Michigan Archive for Research on Child Health). Participants were recruited at first prenatal visit from 22 clinics in 2017-2023. We calculated sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) of self-reported cannabis use using urine toxicology as the criterion standard. 606 participants who self-reported cannabis use data within 30 days of urine collection were considered for analysis. Self-reports identified a prevalence of 14.2% for prenatal cannabis use, whereas urinalysis prevalence was 19.1%. Sensitivity, specificity, PPV, and NPV of self-report were 57.8%, 96.1%, 77.9% and 90.6%, respectively. No significant differences were observed between participants who disclosed and those who did not, except for race and ethnicity. The sensitivity of self-reports among Non-Hispanic Blacks was 45.5% compared to 73.0% for their non-Hispanic White counterparts. Self-reports can underestimate prenatal cannabis use especially among disadvantaged populations. The use of biospecimens to assess cannabis exposure is warranted for reducing misclassification and improving validity in research studies.

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