Department of Pediatrics, Sacred Heart Medical Center at RiverBend, Springfield, Oregon, USA
Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA.
BMJ Open. 2022 Sep 28;12(9):e061167. doi: 10.1136/bmjopen-2022-061167.
Previous literature on the effects of marijuana exposure on neonatal outcomes has been limited by the reliance on maternal self-report. The objective of this study was to examine the relationship of prenatal marijuana exposure on neonatal outcomes in infants with marijuana exposure confirmed with meconium drug testing.
Retrospective cohort study.
Meconium drug screens obtained on infants born in a hospital system in the Pacific Northwest in the USA over a 2.5-year period. 1804 meconium drug screens were initially obtained, with 1540 drug screens included in the analysis.
Neonates with meconium drug screens positive for delta-9-tetrahydrocannabinol (THC) only were compared with neonates with negative drug screens. The following neonatal outcomes were examined: gestational age, preterm birth (<37 weeks), birth weight, low birth weight (defined as birth weight <2.5 kg), length, head circumference, Apgar scores and admission to the neonatal intensive care unit (NICU). Using multivariable logistical and linear regression, we controlled for confounding variables.
1540 meconium drug screens were included in the analysis, with 483 positive for delta-9-THC only. Neonates exposed to delta-9-THC had significantly lower birth weight, head circumference and length (p<0.001). Neonates with THC exposure had 1.9 times the odds (95% CI 1.3 to 2.7, p=0.001) of being defined as low birth weight. Birth weight was on average 0.16 kg lower (95% CI 0.10 to 0.22, p<0.001) in those exposed to THC.
Prenatal marijuana exposure was significantly associated with decreases in birth weight, length and head circumference, and an increased risk of being defined as low birth weight. These findings add to the previous literature demonstrating possible negative effects of prenatal marijuana use on neonatal outcomes.
以往关于大麻暴露对新生儿结局影响的研究受到了对母亲自我报告的依赖的限制。本研究的目的是检查在通过尿液药物检测确认大麻暴露的婴儿中，产前大麻暴露与新生儿结局之间的关系。
回顾性队列研究。
在美国太平洋西北地区的一家医院系统中出生的婴儿的胎粪药物筛查，在 2.5 年的时间内获得了 1804 份胎粪药物筛查，其中 1540 份药物筛查被纳入分析。
胎粪药物筛查中 delta-9-四氢大麻酚（THC）呈阳性的新生儿与药物筛查阴性的新生儿进行比较。检查了以下新生儿结局：胎龄、早产（<37 周）、出生体重、低出生体重（定义为出生体重<2.5 公斤）、长度、头围、阿普加评分和新生儿重症监护病房（NICU）入院。使用多变量逻辑和线性回归，我们控制了混杂变量。
1540 份胎粪药物筛查被纳入分析，其中 483 份仅 delta-9-THC 呈阳性。暴露于 delta-9-THC 的新生儿出生体重、头围和长度明显较低（p<0.001）。暴露于 THC 的新生儿低出生体重的可能性是未暴露组的 1.9 倍（95%CI 1.3 至 2.7，p=0.001）。暴露于 THC 的新生儿的出生体重平均低 0.16 公斤（95%CI 0.10 至 0.22，p<0.001）。
产前大麻暴露与出生体重、长度和头围降低以及低出生体重风险增加显著相关。这些发现增加了以前的文献，证明产前大麻使用可能对新生儿结局产生负面影响。
