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大麻使用与不良产科和新生儿结局之间的关联。

Association between marijuana use and adverse obstetrical and neonatal outcomes.

作者信息

Warshak C R, Regan J, Moore B, Magner K, Kritzer S, Van Hook J

机构信息

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Department of Obstetrics and Gynecology, The Christ Hospital, Cincinnati, OH, USA.

出版信息

J Perinatol. 2015 Dec;35(12):991-5. doi: 10.1038/jp.2015.120. Epub 2015 Sep 24.

Abstract

OBJECTIVE

To evaluate associations between marijuana exposure and adverse outcomes excluding women with polysubstance abuse and stratifying for concurrent maternal tobacco use.

STUDY DESIGN

We performed a retrospective cohort study evaluating various obstetrical and neonatal outcomes including: preterm delivery, pre-eclampsia, gestational diabetes, cesarean delivery, fetal growth restriction, a composite which included stillbirth or neonatal intensive care unit admission, and perinatal mortality. We stratified study groups according to the maternal tobacco use and performed a logistic regression analysis.

RESULTS

We included 6468 women, 6107 nonusers and 361 marijuana users. After adjustment for maternal age, race, parity, body mass index and no prenatal care, we found higher rates of small for gestational age (aOR 1.30 (95% CI 1.03 to 1.62)) and neonatal intensive care unit admission (aOR 1.54 (1.14 to 2.07)) in women who were not tobacco users. Other obstetrical outcomes including preterm delivery and fetal anomalies were not increased with maternal marijuana use.

CONCLUSION

Maternal marijuana use does not increase the risk of adverse obstetrical outcomes or fetal anomalies, but does increase the risk for small for gestational age and neonatal intensive care unit admission.

摘要

目的

评估大麻暴露与不良结局之间的关联,排除存在多种物质滥用的女性,并对同时使用烟草的孕妇进行分层分析。

研究设计

我们进行了一项回顾性队列研究,评估各种产科和新生儿结局,包括:早产、先兆子痫、妊娠期糖尿病、剖宫产、胎儿生长受限、一个包含死产或新生儿重症监护病房入院的综合指标,以及围产期死亡率。我们根据孕妇吸烟情况对研究组进行分层,并进行逻辑回归分析。

结果

我们纳入了6468名女性,其中6107名非使用者和361名大麻使用者。在对孕妇年龄、种族、产次、体重指数和未进行产前检查进行调整后,我们发现非吸烟女性中小于胎龄儿(调整后比值比1.30(95%置信区间1.03至1.62))和新生儿重症监护病房入院率(调整后比值比1.54(1.14至2.07))较高。其他产科结局,包括早产和胎儿畸形,在孕妇使用大麻时并未增加。

结论

孕妇使用大麻不会增加不良产科结局或胎儿畸形的风险,但会增加小于胎龄儿和新生儿重症监护病房入院的风险。

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