Department of Obstetrics and Gynecology (DSH, DND, DSL) and Hatton Research Institute, TriHealth, Cincinnati, Ohio (CGD).
J Addict Med. 2019 Nov/Dec;13(6):436-441. doi: 10.1097/ADM.0000000000000516.
This study aims to clarify any association between infant birth weight and cannabis use in pregnancy based on urine drug screens.
A retrospective medical record review of singleton births from August 2013 through December 2014 with available urine drug screens (UDS) at initiation of prenatal care and delivery was conducted at a large tertiary academic referral center. Patients who used drugs other than cannabis were excluded.
The prevalence of cannabis use in pregnancies not complicated by use of other drugs as evidenced by tetrahydrocannabinol in the urine of 2173 patients was 22.6%. Infants born to mothers who tested positive for only tetrahydrocannabinol in urine at both presentation for prenatal care and delivery were of lower median birth weight compared with those who tested negative [2925 g (IQR 2522-3265) vs 3235 g (IQR 2900-3591), P = <0.001]. There was no clinically relevant difference in gestational age at birth [39.0 weeks (IQR 37.1-40.0) vs 39.3 weeks (IQR 38.3-40.0), P = 0.012] between those positive for tetrahydrocannabinol (THC) and those who tested negative. Concomitant tobacco use during pregnancy was not noted to impact infant birth weight using the analysis of covariance. Higher perinatal mortality was observed among those who used cannabis with an adjusted odds ratio of 4.2 (95% CI, 1.53-11.49).
Cannabis use is negatively correlated with fetal birth weight (up to 450 g less) in patients who tested positive for THC when compared with those who did not as documented in the urine drug screens. On the basis of these findings, additional patient education and cessation interventions should be explored with regard to cannabis use in pregnancy.
本研究旨在根据尿液药物筛查结果，明确婴儿出生体重与孕期使用大麻之间的任何关联。
在一家大型三级学术转诊中心，对 2013 年 8 月至 2014 年 12 月期间有可用产前护理和分娩时尿液药物筛查（UDS）的单胎分娩进行了回顾性病历审查。排除了使用大麻以外的药物的患者。
在未使用其他药物（尿液中四氢大麻酚阳性）的情况下，2173 例妊娠中大麻使用的患病率为 22.6%。与尿液中四氢大麻酚检测均为阴性的母亲所生婴儿相比，尿液中仅四氢大麻酚检测阳性的母亲所生婴儿的中位数出生体重较低[2925g（IQR 2522-3265）比 3235g（IQR 2900-3591），P<0.001]。出生时的胎龄[39.0 周（IQR 37.1-40.0）比 39.3 周（IQR 38.3-40.0），P=0.012]在四氢大麻酚阳性者和阴性者之间无临床相关差异。使用协方差分析，未发现孕期同时使用烟草会影响婴儿的出生体重。与未使用大麻的患者相比，使用大麻的患者围产期死亡率更高，调整后的优势比为 4.2（95%CI，1.53-11.49）。
与尿液药物筛查未检测到 THC 的患者相比，尿液药物筛查检测到 THC 的患者的胎儿出生体重（低至 450g）呈负相关。基于这些发现，应该探讨针对孕期使用大麻的患者进行额外的患者教育和戒烟干预。
