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孕产妇大麻使用特征 - 八个州,妊娠风险评估监测系统,2017 年。

Characteristics of Marijuana Use During Pregnancy - Eight States, Pregnancy Risk Assessment Monitoring System, 2017.

出版信息

MMWR Morb Mortal Wkly Rep. 2020 Aug 14;69(32):1058-1063. doi: 10.15585/mmwr.mm6932a2.

Abstract

Marijuana is the most commonly used illicit substance under federal law in the United States (1); however, many states have legalized medical and adult nonmedical use. Evidence regarding the safety and health effects of cannabis use during pregnancy is largely inconclusive (2). Potential adverse health effects to exposed infants (e.g., lower birthweight) have been documented (2). To provide population-based estimates of use surrounding pregnancy, identify reasons for and mode of use, and understand characteristics of women who continue versus cease marijuana use during pregnancy, CDC analyzed data from eight states participating in the 2017 Pregnancy Risk Assessment Monitoring System (PRAMS) marijuana supplement. Overall, 9.8% of women self-reported marijuana use before pregnancy, 4.2% during pregnancy, and 5.5% after pregnancy. The most common reasons for use during pregnancy were to relieve stress or anxiety, nausea or vomiting, and pain. Smoking was the most common mode of use. In multivariable models that included age, race/ethnicity, marital status, education, insurance status, parity, trimester of entry into prenatal care, and cigarette and e-cigarette use during pregnancy, women who continued versus ceased marijuana use during pregnancy were more likely to be non-Hispanic white or other race/ethnicity than non-Hispanic black, be unmarried, have ≤12 years of education, and use cigarettes during pregnancy. The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) recommend refraining from marijuana use during pregnancy and lactation (3,4). Given the increasing number of states legalizing medical and adult nonmedical marijuana use, surveillance of perinatal marijuana use can inform clinical guidance, provider and patient education, and public health programs to support evidence-based approaches to addressing substance use.

摘要

在美国,大麻是根据联邦法律规定的最常被滥用的非法物质(1);然而,许多州已经将医用和成人非医用大麻合法化。关于怀孕期间使用大麻的安全性和健康影响的证据基本上没有定论(2)。已经有研究记录了暴露于大麻中的婴儿可能会出现不良健康影响(例如,出生体重较低)(2)。为了提供有关怀孕期周围使用情况的人群估计,确定使用原因和方式,并了解在怀孕期间继续或停止使用大麻的女性的特征,CDC 分析了来自参与 2017 年妊娠风险评估监测系统(PRAMS)大麻补充调查的八个州的数据。总体而言,9.8%的女性在怀孕前自我报告使用过大麻,4.2%的女性在怀孕期间使用,5.5%的女性在怀孕后使用。怀孕期间使用的最常见原因是缓解压力或焦虑、恶心或呕吐和疼痛。吸烟是最常见的使用方式。在包含年龄、种族/族裔、婚姻状况、教育程度、保险状况、生育次数、产前护理进入的妊娠阶段以及怀孕期间吸烟和电子烟使用情况的多变量模型中,与怀孕期间停止使用大麻的女性相比,继续使用大麻的女性更有可能是非西班牙裔白人或其他种族/族裔,未婚,教育程度≤12 年,怀孕期间吸烟。美国妇产科医师学会(ACOG)和美国儿科学会(AAP)建议在怀孕期间和哺乳期避免使用大麻(3,4)。鉴于越来越多的州将医用和成人非医用大麻合法化,对围产期大麻使用情况的监测可以为临床指导、提供者和患者教育以及公共卫生计划提供信息,以支持采用基于证据的方法来解决物质使用问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/442a/7440118/a7520ef67d6f/mm6932a2-F1.jpg

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