[with Marc's comment] Prenatal Cannabis Use and Maternal Pregnancy Outcomes
rael-science
The Raelian Movement
Get Rael-Science on Facebook: http://www.facebook.com/raelscience
Get Rael-Science on Twitter: https://twitter.com/rael_science
Prenatal Cannabis Use and Maternal Pregnancy Outcomes
- PMID: 39037795
- PMCID: PMC11264060
- DOI: 10.1001/jamainternmed.2024.3270
Abstract
Importance: Many studies have evaluated whether in utero cannabis exposure is associated with fetal and neonatal outcomes, yet little is known about whether prenatal cannabis use is associated with maternal health outcomes during pregnancy.
Objective: To evaluate whether prenatal cannabis use is associated with maternal health outcomes during pregnancy.
Design, setting, and participants: This population-based retrospective cohort study included pregnancies in Northern California from January 2011 to December 2019 that lasted 20 weeks or longer and were screened for prenatal cannabis use.
Exposures: Prenatal cannabis use was defined as any self-reported use during early pregnancy or a positive toxicology test result based on universal screening at entrance to prenatal care (approximately 8-10 weeks' gestation). Self-reported frequency of use (daily, weekly, monthly or less, never, unknown), use defined only by self-report, and use defined only by toxicology test results were examined.
Main outcomes and measures: Electronic health record data were used to define the following outcomes: gestational hypertension, preeclampsia, eclampsia, gestational diabetes, gestational weight gain greater and less than guidelines, placenta previa, placental abruption, placenta accreta, and severe maternal morbidity. Adjusted risk ratios (aRRs) were calculated using a modified Poisson regression.
Results: The sample (n = 316 722 pregnancies; 250 221 unique individuals) included 84 039 (26.5%) Asian/Pacific Islander, 20 053 (6.3%) Black, 83 145 (26.3%) Hispanic, and 118 333 (37.4%) White individuals; the mean (SD) age was 30.6 (5.4) years. Overall, 20 053 (6.3%) screened positive for prenatal cannabis use; 2.9% were positive by self-report, 5.3% by toxicology testing, and 1.8% by both. The frequency of cannabis use was 1930 (0.6%) daily, 2345 (0.7%) weekly, 4892 (1.5%) monthly or less, and 10 886 (3.4%) unknown. Prenatal cannabis use was associated with greater risk of gestational hypertension (aRR, 1.17; 95% CI, 1.13-1.21), preeclampsia (aRR, 1.08; 95% CI, 1.01-1.15), weight gain less than (aRR, 1.05; 95% CI, 1.01-1.08) and greater than (aRR, 1.09; 95% CI, 1.08-1.10) guidelines, and placental abruption (aRR, 1.19; 95% CI, 1.05-1.36). The pattern of results was similar when defining prenatal cannabis use only by self-report or only by toxicology testing, and associations between the frequency of prenatal cannabis use and outcomes varied with outcome.
Conclusions and relevance: The results of this cohort study suggest that prenatal cannabis use was associated with several adverse maternal health outcomes during pregnancy. Continued research is needed to understand whether characteristics of prenatal cannabis use (eg, dose, mode, and timing) moderate these associations.
Conflict of interest statement
Conflict of Interest Disclosures: Dr Young-Wolff reported grants from the National Institute on Drug Abuse (NIDA) during the conduct of the study. Drs Alexeeff and Avalos and Ms Slama reported grants from the National Institutes of Health (NIH) during the conduct of the study. Ms Does reported research support from the Industry PMR Consortium outside the submitted work. Dr Silver reported grants from NIDA/NIH via a Kaiser Permanente subaward during the conduct of the study. No other disclosures were reported.
Figures
Comment in
- doi: 10.1001/jamainternmed.2024.3276