Vanderziel Alyssa, Anthony James C, Barondess David, Kerver Jean M, Alshaarawy Omayma
Center for Health Policy & Health Services Research, Henry Ford Health, Detroit, Michigan, USA.
Department of Epidemiology & Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
Am J Addict. 2025 Jan;34(1):21-29. doi: 10.1111/ajad.13650. Epub 2024 Sep 5.
Prenatal cannabis use prevalence in the United States has increased. Relaxation of state-level cannabis policy may be contributing to the diminished risk perception of using cannabis. The main psychoactive constituent of cannabis, delta-9-tetrahydrocannabinol, crosses the placenta, interacting with functional cannabinoid receptors in the fetus. Here, we assess the association between prenatal cannabis exposure (PCE) and a set of birth outcomes.
Using the Michigan Archive for Research on Child Health, a prospective pregnancy cohort, we linked prenatal survey data with neonatal data from state-archived birth records. Recruitment occurred in 23 clinics across Michigan. Pregnant participants with live birth records between October 2017 and January 2022, after exclusion for missing data on cannabis use, birth outcomes, and covariates, were included in the final analytic sample (n = 584). Analyses involved generalized linear models.
An estimated 15% (95% confidence interval [CI]: 12%, 18%) of participants reported using cannabis during pregnancy. Covariate-adjusted models revealed an association between PCE and birth size (ß = -0.3; 95% CI: -0.5, -0.003).
Findings suggest a relationship between PCE and smaller birth size. Clinicians should follow guidelines outlined by the American College of Obstetricians and Gynecologists when counseling pregnant patients on cannabis use.
We detected a significant association between PCE and birth size. Most studies focus only on the extremes of birth size, however, use of z-scores allow for assessment of the sex-specific birth weight-for-gestational age distribution, increasing the accuracy of detecting an effect of cannabis exposure on birth size.
美国孕期大麻使用的患病率有所上升。州级大麻政策的放宽可能导致对使用大麻风险的认知降低。大麻的主要精神活性成分Δ-9-四氢大麻酚可穿过胎盘，与胎儿体内的功能性大麻素受体相互作用。在此，我们评估孕期大麻暴露（PCE）与一系列出生结局之间的关联。
利用密歇根儿童健康研究档案（一个前瞻性妊娠队列），我们将产前调查数据与来自州存档出生记录的新生儿数据相链接。招募工作在密歇根州的23家诊所进行。在排除大麻使用、出生结局和协变量方面的缺失数据后，2017年10月至2022年1月间有活产记录的孕妇参与者被纳入最终分析样本（n = 584）。分析采用广义线性模型。
估计有15%（95%置信区间[CI]：12%，18%）的参与者报告在孕期使用过大麻。经协变量调整的模型显示PCE与出生体重之间存在关联（β = -0.3；95% CI：-0.5，-0.003）。
研究结果表明PCE与较小出生体重之间存在关联。临床医生在为孕妇提供关于大麻使用的咨询时应遵循美国妇产科医师学会概述的指南。
我们检测到PCE与出生体重之间存在显著关联。然而，大多数研究仅关注出生体重的极端情况，使用z分数可评估特定性别的出生体重与胎龄分布，提高检测大麻暴露对出生体重影响的准确性。
