More American women are using marijuana during their pregnancies, a study by researchers including from the University of Georgia has found.

In 2021, about 7% of pregnant women have used marijuana, an increase from roughly 3% reported in 2002, the study said.

The study was based on federal National Survey on Drug Use and Health data from 2015 to 2021. The study sample included 4,338 women who were pregnant at the time of the survey and had complete information on marijuana use during the past 30 days.

The findings, published in the American Journal on Addictions, found the majority of marijuana users live in states where medical marijuana was legalized. Marijuana use is legal for recreational use in 25 states and for medical purposes in 14 more. Recreational marijuana use remains illegal in Georgia, though eligible patients may buy low-THC medical marijuana products with up to 5% THC, the compound that gives users a high.

Most of the women who used marijuana were in their first trimester of pregnancy, between the ages of 18 to 25 years old and perceived no risk associated with weekly marijuana use. The study says some expectant mothers perceive marijuana as a potential remedy for pregnancy-related symptoms such as nausea and vomiting.

Researchers are worried about marijuana use during pregnancy.

“Prenatal exposure to marijuana has been associated with adverse birth outcomes, including low birth weight, fetal growth restriction, premature birth, stillbirth, and neurodevelopmental effects that can extend into young adulthood,” the study said.

Lead researcher Mohammad Rifat Haider, an assistant professor in UGA’s College of Public Health, said in a statement: “Long story short, this is a very vulnerable population, and evidence shows that during pregnancy, marijuana use is detrimental for both mother and child. There needs to be policy direction from the state to have these discussions.”

UGA College of Public Health professor Nathan B. Hansen also participated in the study.

The study noted other research that has found women who use marijuana during pregnancy are more likely to use alcohol, tobacco, opioids and other illicit drugs.

The study’s authors said clinicians should be equipped with resources to offer screening, patient education and care for women who use marijuana during pregnancy.

“In a constantly changing legal landscape surrounding marijuana, it becomes imperative to provide clear and unambiguous messaging regarding the adverse effects of marijuana use during pregnancy,” the authors wrote.