Number of newborns exposed to pot in Colo. exaggerated, but data lacking
Author: Kaitlin Durbin - October 9, 2018 - Updated: October 29, 2018
When one Colorado hospital reported 50 percent of babies born in a single month had marijuana in their systems, a public health hysteria took root, with the image of a statewide epidemic of high newborns embellished in each retelling.
At best, the facts were unintentionally distorted, a Gazette inquiry has found. At worst, they were misrepresented for political effect.
St. Mary-Corwin Medical Center in Pueblo reported in July 2016, when it still had a labor and delivery unit, that “nearly half of the newborns born in March 2016 at St. Mary-Corwin who were drug tested due to suspected pre-natal exposure tested positive for marijuana.”
Newborns “who were drug tested” is the key phrase often absent from the statistic when it has been repeated in the community by politicians and anti-pot officials. Because what the numbers show is that of the 52 babies born at St. Mary’s that month, only 11 were drug tested, and of those 11, five were positive for THC.
So while it may be true that 45 percent or “nearly half” of the babies tested at the Pueblo hospital that March were positive for marijuana, that subset is less than 10 percent of babies born that month.
St. Mary’s argued that “While a small subset, … the results are certainly indicative of a concerning trend,” but they have no data to back up whether the percentage is higher or lower than other years. The hospital doesn’t have records of positive tests before March 2016, and apparently didn’t keep them afterward, either.
The hospital initially indicated it did keep the records and was preparing to turn them over to The Gazette in response to a public records request, but after two months hospital spokeswoman Jillian Maes said “it is simply not available … We do not have any more recent data for babies.”
The number of newborns testing positive for marijuana statewide simply isn’t known.
The Colorado Department of Public Health and Environment, the state’s public health record keeper, said it does not “receive or track data” on THC-positive infants across the state because there is no consistency between the hospitals about who gets tested. However, in one of its survey from 2016, 7.8 percent of mothers admitted to using the drug at some point during their pregnancy.
If a mother admits to using, every hospital requires urine and umbilical cord testing on her and the baby. Otherwise, testing is left up to each hospital’s staff’s discretion, based on perceived risk factors, signs of use or because the mother didn’t participate in regular prenatal visits.
Colorado hospitals report
In the absence of statewide data, The Gazette reached out to the three other hospitals that deliver babies in El Paso and Pueblo counties to see whether their data reflected an alarming trend of THC-positive babies, but their statistics are similar — less than half of the babies born are tested, and those that are positive for marijuana account for 5 percent or less of the newborn population.
• Penrose-St. Francis Health Services doesn’t track drug tests on babies, but medical social worker Jeanne Moore started keeping her records in March 2015. She only records positive tests results, but her records show that of 10,487 babies born at the hospital between March 2015 and June 2018, 248 of them — or about 2 percent — were positive for THC.
• UCHealth Memorial’s two hospitals began testing some newborn umbilical cords for cannabinoids in October 2015. It found that of the roughly 4,600 babies born at the hospitals in a given year, less than 1,000 are tested and of those, less than half are positive for any drug. In the years 2016 and 2017, for example, about 200 babies tested positive for marijuana, which equates to 30 percent or less of the babies tested and 4 percent of babies born.
• Parkview Medical Center in Pueblo has been tracking THC in newborns since at least 2013. Its records show that of the roughly 1,500 babies born there each year, less than 250 are tested — a number that has doubled since 2013 — but only about a third are positive for marijuana. The positives represent 5 percent or less of the newborn population.
The number of infants tested continues to increase each year, as do the number of positive results, according to hospital data. At Memorial, the difference between its two full years of data in 2016 and 2017 is about 50 babies. Penrose-St. Francis didn’t break down its number by year, but Moore said they’ve held a steady pace of about 8 positive tests per month, which would equate to roughly 100 babies a year.
Parkview’s increase appears the most dramatic, spiking from 5 positive tests in 2013 to as many as 85 in recent years, but the number of positives remains below figures at the other two hospitals.
“I am always concerned about drug exposure but I don’t think that it’s at a point where we need to be overreacting,” Moore, a 28-year medical social worker, said of the figures. “We need to be educational, prudent, informed, but we don’t need to be hysterical.”
When you put it into context, there aren’t a lot of drugged babies being born in the state, Moore said.
The problem is, few people who use the statistic put it into context.
Industry, law enforcement dispute
District Attorney Dan May is among the officials who cite the figure most often in news conferences and speeches to bolster his view of the negative impact marijuana has had on the state. The most recent case was over the summer during a joint announcement with area law enforcement on the exploding black market for marijuana. May said:
“In 2016, they asked all the hospitals, are you seeing more babies born with marijuana? Every hospital in the state of Colorado reported that it had an increase … The hospital down in Pueblo reported 48 percent of the babies were born with marijuana in their system at birth. That’s 50 percent of babies in Pueblo.”
That narrative is “demonizing cannabis” and unfairly feeding “reefer madness” in the state, said Ashley Weber with Colorado NORML, a pro-marijuana organization that advocates for cannabis law reforms.
It’s not just the public opinion Weber says she’s worried about.
Marijuana at the federal level remains a Schedule I illegal substance, so Colorado law requires that parents whose babies test positive for the drug be reported to social services for investigation of child abuse. Most of the time those reports are quickly ruled unfounded, but Weber said more parents this year are calling frantic that their county’s social services agency is threatening to remove their children from the home because they tested positive for marijuana at birth. She worries “misleading information” might be driving the trend.
“Cannabis is not grounds for bad parenting,” Weber said.
Social service agencies disagree with Weber, to varying degrees.
The El Paso County Department of Human Services receives roughly 16,000 referrals a year alleging child abuse or neglect, less than half of which are assigned for deeper investigation and “a smaller percentage of those” are determined to be founded, Child Protection Manager Krystal Grint said.
It’s impossible to parse how many of the reports that escalate to full DHS cases involve newborns testing positive for marijuana. Hospital records show that roughly 100 babies in El Paso County tested positive for marijuana in the first few months of this year, which means there could be 100 DHS reports. But Grint said that in the first half of the year they opened only 68 cases related to drug use, though they can’t say which drug or at what point the parent used.
Either way, Grint said it would take more than a positive marijuana test at birth to initiate DHS action. It would have to be compounded by other issues that could “really impact the ability to properly provide caregiving to the child,” such as how often the parent uses, if they have a safety plan for their child while they use, if other family members are concerned about the child’s safety, if other drugs are involved, if domestic violence is involved or if parents can’t support the child financially.
Susanna Prensner, a three-year medical social worker at Penrose-St. Francis, said that in Pueblo County marijuana use during pregnancy is “so common” that when they report a mother, the Pueblo County Department of Social Services tells them it’s not likely to follow up on it.
Two program administrators with Pueblo’s social services agency called the allegation “not necessarily true,” because the office assesses each of its roughly 2,000 referrals a year. They didn’t have figures readily available to show how many of their referrals or case reports involved drugs.
Health department warnings
Meanwhile, messaging by government agencies, pediatricians and others warn against marijuana use while pregnant or breastfeeding.
The Colorado health department says on its website that using marijuana during pregnancy or while breastfeeding “may make it hard for your child to pay attention and learn, especially as your child grows older. This would make it harder for your child to do well in school.”
The American Academy of Pediatrics this summer also doubled down on the same message after two studies published this year found that 70 percent of cannabis dispensaries in Colorado were recommending their products to expectant mothers with morning sickness, and that infant exposures across the nation increased 62 percent after legalization.
“The fact that marijuana is legal in many states may give the impression the drug is harmless during pregnancy, especially with stories swirling on social media about using it for nausea with morning sickness,” a lead author of the latter study, Dr. Sheryl A. Ryan, said. “But in fact, this is still a big question.”
Very little is known about the effects of marijuana exposure on infants. Most research depends on anecdotal information provided by parents after the fact. But Ryan says “based on the limited data that does exist, as pediatricians, we believe there is cause to be concerned about how the drug will impact the long-term development of children.”
A University of Colorado Anschutz Medical Campus study this summer also associated marijuana use during pregnancy with a 50 percent increased likelihood of low birth weight.
Memorial Hospital seems to support the study’s correlation between marijuana use and low birth weight, but linking it to premature births. The hospital tests all mothers who give birth within the first 36 weeks of gestation — full-term is 40 weeks — when the labor is not attributable to some other cause, such as a car crash, an infection or pre-eclampsia. Though records reflecting how often that happens were not provided.
Parkview also reports that in the last five years, up to 25 percent of the babies born there who tested positive for marijuana were delivered premature.
Moore, with Penrose-St. Francis, said, “There is no direct correlation between a baby’s size or gestational age and marijuana use.” The hospital doesn’t track premature births or birth weights for babies who test positive for the drug, she said.
Unlike babies exposed to meth or heroin, marijuana babies show no immediate side effects, Moore said, but, like Ryan and Sabet, she suspects damaging consequences wouldn’t present themselves until later in the child’s life. She wondered why mothers would take the risk.
“We don’t have anyone saying marijuana is harmful yet, but we will.”
Colorado NORML also doesn’t recommend mothers “consume any drugs while pregnant,” Weber said, but it does believe “cannabis would be the safest and most effective natural option if the mother needed medical treatment” for severe issues with nausea, seizures or inflammation.
Based on their research and anecdotal information from parents whose children are now 10 years old, early marijuana exposure “doesn’t even have an effect,” Weber said.