2007-2020 年美国生育中心协会围产期数据注册研究中的妊娠期大麻使用结局：助产主导型护理中的机会。

Outcomes of Cannabis Use During Pregnancy Within the American Association of Birth Centers Perinatal Data Registry 2007-2020: Opportunities Within Midwifery-Led Care.

机构信息

El Rio Health, Tucson, Arizona (Ms Joseph-Lemon); Elephant Circle, Palisade, Colorado (Dr Thompson); Conemaugh OB/Gyne Associates, Duke Life Point Conemaugh, Johnstown, Pennsylvania (Dr Verostick); Mel and Enid Zuckerman College of Public Health, the University of Arizona, Tucson (Ms Shizuka Oura); and Frontier Nursing University, Versailles, Kentucky (Dr Jolles).

出版信息

J Perinat Neonatal Nurs. 2022;36(3):264-273. doi: 10.1097/JPN.0000000000000668.

DOI:10.1097/JPN.0000000000000668

PMID:35894723

Abstract

BACKGROUND

Healthcare providers require data on associations between perinatal cannabis use and birth outcomes.

METHODS

This observational secondary analysis come from the largest perinatal data registry in the United States related to the midwifery-led birth center model care (American Association of Birth Centers Perinatal Data Registry; N = 19 286). Births are planned across all birth settings (home, birth center, hospital); care is provided by midwives and physicians.

RESULTS

Population data show that both early and persistent self-reports of cannabis use were associated with higher rates of preterm birth, low-birth-weight, lower 1-minute Apgar score, gestational weight gain, and postpartum hemorrhage. Once controlled for medical and social risk factors using logistic regression, differences for childbearing people disappeared except that the persistent use group was less likely to experience "no intrapartum complications" (adjusted odds ratio [aOR] = 0.49; 95% confidence interval [CI], 0.32-0.76; P < .01), more likely to experience an indeterminate fetal heart rate in labor (aOR = 3.218; 95% CI, 2.23-4.65; P < .05), chorioamnionitis (aOR = 2.8; 95% CI, 1.58-5.0; P < .01), low-birth-weight (aOR = 1.8; 95% CI, 1.08-3.05; P < .01), and neonatal intensive care unit (NICU) admission (aOR = 2.4; 95% CI, 1.30-4.69; P < .05).

CONCLUSIONS

Well-controlled data demonstrate that self-reports of persistent cannabis use through the third trimester are associated with an increased risk of low-birth-weight and NICU admission.

摘要

背景

医疗保健提供者需要有关围产期大麻使用与生育结果之间关联的数据。

方法

本观察性二次分析来自美国最大的与助产士主导的生育中心模式护理相关的围产期数据登记处（美国生育中心协会围产期数据登记处；N=19286）。分娩计划在所有分娩环境（家庭、生育中心、医院）中进行；由助产士和医生提供护理。

结果

人群数据显示，早期和持续的自我报告大麻使用与早产、低出生体重、低 1 分钟 Apgar 评分、妊娠体重增加和产后出血的发生率较高有关。一旦使用逻辑回归控制了医疗和社会风险因素，除了持续使用组不太可能经历“无分娩并发症”（调整后的优势比[aOR]=0.49；95%置信区间[CI]，0.32-0.76；P<.01）之外，对于生育人群的差异消失了，更有可能在分娩时出现不确定的胎儿心率（aOR=3.218；95%CI，2.23-4.65；P<.05）、绒毛膜羊膜炎（aOR=2.8；95%CI，1.58-5.0；P<.01）、低出生体重（aOR=1.8；95%CI，1.08-3.05；P<.01）和新生儿重症监护病房（NICU）入院（aOR=2.4；95%CI，1.30-4.69；P<.05）。