Obstetrics Department, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Psychiatry Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Acta Obstet Gynecol Scand. 2022 Nov;101(11):1207-1214. doi: 10.1111/aogs.14439. Epub 2022 Aug 30.
Cannabis consumption during pregnancy increases the risk of pregnancy and neonatal complications. Since the underlying mechanism is unknown, the purpose of this study is to evaluate the changes in maternal and fetal blood flow in pregnancies exposed to cannabis, Δ9-tetrahydrocannabinol (THC).
A case-control study between 2013 and 2020, included women with continued cannabis exposure during the pregnancies, defined by qualitative detection of THC in urine (Cannabis Group), and low-risk pregnancy women divided into tobacco smokers (Tobacco Group), and non-tobacco smokers (Control Group). We evaluated the association between cannabis consumption and maternal and fetal blood flow parameters measured by Doppler ultrasound: uterine artery at 11-14, 20-22 and 33-35 weeks, umbilical artery and middle cerebral artery at 33-35 weeks. Cerebral-placental ratio was calculated.
Overall, 275 participants were included, 60 in the Cannabis Group, 17 in the Tobacco Group and 198 in the Control Group. At 33-35 weeks, differences were found in the umbilical artery pulsatility index (PI) (1.05 ± 0.23, 1.06 ± 0.19, 0.93 ± 0.15, P < 0.01), middle cerebral artery PI (1.75 ± 0.35, 1.90 ± 0.45, 1.88 ± 0.34, P < 0.05), cerebral-placental ratio (1.69 ± 0.40, 1.85 ± 0.53, 2.07 ± 0.47, P < 0.05) and mean uterine artery PI (0.89 ± 0.26, 0.73 ± 0.19, 0.74 ± 0.20, P < 0.01), respectively. On logistic regression analysis, adjusted for maternal age, maternal body mass index, maternal weight and white ethnicity, both cannabis and tobacco were predictors for increased umbilical artery PI, but only cannabis was a predictor for a decreased cerebral-placental ratio and an increased uterine artery PI at 33-35 weeks.
Data from a large cohort of continuous cannabis exposure pregnancies show that cannabis is associated with maternal and fetal blood flow changes. However, it is not possible to disentangle the association of the tobacco and cannabis.
孕期吸食大麻会增加妊娠和新生儿并发症的风险。由于其潜在机制尚不清楚，本研究旨在评估暴露于大麻中母体和胎儿血流的变化，大麻中含有 Δ9-四氢大麻酚（THC）。
这是一项 2013 年至 2020 年期间的病例对照研究，纳入了尿液中定性检测到 THC 的持续吸食大麻的孕妇（Cannabis 组），以及分为吸烟组（Tobacco 组）和非吸烟组（Control 组）的低风险妊娠孕妇。我们评估了大麻消费与通过多普勒超声测量的母体和胎儿血流参数之间的关系：11-14、20-22 和 33-35 周的子宫动脉，33-35 周的脐动脉和大脑中动脉。计算脑胎盘比。
共有 275 名参与者，包括 60 名 Cannabis 组、17 名 Tobacco 组和 198 名 Control 组。在 33-35 周时，发现脐动脉搏动指数（PI）（1.05±0.23、1.06±0.19、0.93±0.15，P<0.01）、大脑中动脉 PI（1.75±0.35、1.90±0.45、1.88±0.34，P<0.05）、脑胎盘比（1.69±0.40、1.85±0.53、2.07±0.47，P<0.05）和平均子宫动脉 PI（0.89±0.26、0.73±0.19、0.74±0.20，P<0.01）分别存在差异。经多元逻辑回归分析，调整了母亲年龄、母亲体重指数、母亲体重和白种人种族后，大麻和烟草均为脐动脉 PI 增加的预测因子，但只有大麻与 33-35 周时脑胎盘比降低和子宫动脉 PI 增加相关。
来自大量持续吸食大麻妊娠的队列数据表明，大麻与母体和胎儿血流变化有关。但是，无法区分烟草和大麻的关联。
