From the Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR (KCP, SH, BG, AEB, ABC, JOL); and Department of Pediatrics, Oregon Health & Science University, Portland, OR (MAH).
J Addict Med. 2023;17(3):e192-e198. doi: 10.1097/ADM.0000000000001123. Epub 2022 Dec 13.
With legislative changes to cannabis legalization and increasing prevalence of use, cannabis is the most commonly used federally illicit drug in pregnancy. Our study aims to assess the perinatal outcomes associated with prenatal cannabis use disorder.
We conducted a retrospective cohort study using California linked hospital discharge-vital statistics data and included singleton, nonanomalous births occurring between 23 and 42 weeks of gestational age. χ 2 Test and multivariable logistic regression were used for statistical analyses.
A total of 2,380,446 patients were included, and 9144 (0.38%) were identified as using cannabis during pregnancy. There was a significantly increased risk for adverse birthing person outcomes, including gestational hypertension (adjusted odds ratio [AOR], 1.19; 95% confidence interval [CI], 1.06-1.34; P = 0.004), preeclampsia (AOR, 1.16; 95% CI, 1.0-1.28; P = 0.006), preterm delivery (AOR, 1.45; 95% CI, 1.35-1.55; P < 0.001), and severe maternal morbidity (AOR, 1.22; 95% CI, 1.02-1.47; P = 0.033). Prenatal cannabis use disorder was also associated with an increased risk of neonatal outcomes including respiratory distress syndrome (AOR, 1.16; 95% CI, 1.07-1.27; P < 0.001), small for gestational age (AOR, 1.47; 95% CI, 1.38-1.56; P < 0.001), neonatal intensive care unit admission (AOR, 1.24; 95% CI, 1.16-1.33; P < 0.001), and infant death (AOR, 1.86; 95% CI, 1.44-2.41; P < 0.001). There was no statistically significant difference in stillbirth (AOR, 0.96; 95% CI, 0.69-1.34; P = 0.80) and hypoglycemia (AOR, 1.22; 95% CI, 1.00-1.49; P = 0.045).
Our study suggests that prenatal cannabis use disorder is associated with increased maternal and neonatal morbidity and mortality. As cannabis use disorder in pregnancy is becoming more prevalent, our findings can help guide preconception and prenatal counseling.
随着大麻合法化立法的改变和使用率的增加，大麻是怀孕期间最常被使用的联邦违禁药物。我们的研究旨在评估与产前大麻使用障碍相关的围产期结局。
我们使用加利福尼亚州关联医院出院-生命统计数据进行了回顾性队列研究，并纳入了 23 至 42 周妊娠期的单胎、非异常出生。χ 2 检验和多变量逻辑回归用于统计分析。
共纳入 2380446 名患者，9144 名（0.38%）被确定为怀孕期间使用大麻。不良分娩结局的风险显著增加，包括妊娠期高血压（调整后的优势比 [AOR]，1.19；95%置信区间 [CI]，1.06-1.34；P=0.004）、子痫前期（AOR，1.16；95%CI，1.0-1.28；P=0.006）、早产（AOR，1.45；95%CI，1.35-1.55；P<0.001）和严重产妇发病率（AOR，1.22；95%CI，1.02-1.47；P=0.033）。产前大麻使用障碍也与新生儿结局风险增加相关，包括呼吸窘迫综合征（AOR，1.16；95%CI，1.07-1.27；P<0.001）、小于胎龄儿（AOR，1.47；95%CI，1.38-1.56；P<0.001）、新生儿重症监护病房入院（AOR，1.24；95%CI，1.16-1.33；P<0.001）和婴儿死亡（AOR，1.86；95%CI，1.44-2.41；P<0.001）。死产（AOR，0.96；95%CI，0.69-1.34；P=0.80）和低血糖症（AOR，1.22；95%CI，1.00-1.49；P=0.045）的统计学差异无意义。
我们的研究表明，产前大麻使用障碍与产妇和新生儿发病率和死亡率增加有关。由于怀孕期间大麻使用障碍的发生率越来越高，我们的研究结果可以帮助指导孕前和产前咨询。
