Leemaqz Shalem Y, Dekker Gustaaf A, McCowan Lesley M, Kenny Louise C, Myers Jenny E, Simpson Nigel A B, Poston Lucilla, Roberts Claire T
Robinson Research Institute, School of Medicine, University of Adelaide, Adelaide, South Australia 5005, Australia.
Robinson Research Institute, School of Medicine, University of Adelaide, Adelaide, South Australia 5005, Australia; Department of Obstetrics and Gynaecology, Lyell McEwin Hospital, Elizabeth, South Australia, Australia.
Reprod Toxicol. 2016 Jul;62:77-86. doi: 10.1016/j.reprotox.2016.04.021. Epub 2016 Apr 30.
Widespread legalisation of marijuana raises safety concerns for its use in pregnancy. This study investigated the association of marijuana use prior to and during pregnancy with pregnancy outcomes in a prospective cohort of 5588 nulliparous women from the international SCOPE study. Women were assessed at 15±1 and 20±1 weeks' gestation. Cases [278 Preeclampsia, 470 gestational hypertension, 633 small-for-gestational-age, 236 spontaneous preterm births (SPTB), 143 gestational diabetes] were compared separately with 4114 non-cases. Although the numbers are small, continued maternal marijuana use at 20 weeks' gestation was associated with SPTB independent of cigarette smoking status [adj OR 2.28 (95% CI:1.45-3.59)] and socioeconomic index (SEI) [adj OR 2.17 (95% CI:1.41-3.34)]. When adjusted for maternal age, cigarette smoking, alcohol and SEI, continued maternal marijuana use at 20 weeks' gestation had a greater effect size [adj OR 5.44 (95% CI 2.44-12.11)]. Our data indicate that increasing use of marijuana among young women of reproductive age is a major public health concern.
大麻的广泛合法化引发了其在孕期使用的安全性担忧。本研究在国际SCOPE研究中对5588名未生育女性的前瞻性队列中，调查了孕期及孕前大麻使用与妊娠结局之间的关联。在妊娠15±1周和20±1周时对女性进行评估。将病例组[278例先兆子痫、470例妊娠期高血压、633例小于胎龄儿、236例自发性早产（SPTB）、143例妊娠期糖尿病]分别与4114例非病例组进行比较。尽管数量较少，但妊娠20周时母亲持续使用大麻与自发性早产相关，且独立于吸烟状况[校正比值比2.28（95%可信区间：1.45 - 3.59）]和社会经济指数（SEI）[校正比值比2.17（95%可信区间：1.41 - 3.34）]。在对母亲年龄、吸烟、饮酒和SEI进行校正后，妊娠20周时母亲持续使用大麻的效应量更大[校正比值比5.44（95%可信区间2.44 - 12.11）]。我们的数据表明，育龄期年轻女性中大麻使用的增加是一个主要的公共卫生问题。
