Sennott Christie, Lindsay Sadé, Kelly Brian, Vuolo Mike
Purdue University.
Cornell University.
Popul Res Policy Rev. 2022 Aug;41(4):1809-1829. doi: 10.1007/s11113-022-09714-6. Epub 2022 Apr 11.
As states liberalize their cannabis laws, cannabis use has become more widespread among adults across the United States, including pregnant women. As a result, recent research has investigated the potential effects of prenatal cannabis use on child health, with mixed results. In this study, we investigate the relationship between the liberalization of state-level cannabis possession laws and two birth outcomes indicative of child health: birthweight and gestational age. Drawing on 2003-2019 data from CDC WONDER, the American Community Survey, and multiple legal databases, we use fixed effects models to examine how changes in cannabis policies-moving from a misdemeanor to decriminalized to legalized possession-have influenced state-level averages in birthweight and gestational age and percentages of births classified as low birthweight (<2500g) and preterm (<37 weeks). We account for state-level factors including medical cannabis laws, health-related policies, spending patterns, and demographic characteristics known to influence health. Results indicate that the liberalization of state cannabis possession laws was associated with statistically significant reductions in average birthweight, and to a lesser extent gestational age, with significant effects for subgroups of women by age, race/ethnicity, and risk factors including chronic hypertension and diabetes. However, we did not find increases in the percentage of women with clinically relevant low birthweight or preterm births following cannabis policy liberalization. Although our study does not show substantial changes in adverse birth outcomes, policymakers should be attentive to opportunities to strengthen child health by considering policies that minimize consumption, particularly heavier forms of consumption, by prospective parents.
随着各州放宽大麻法律，大麻使用在美国成年人中变得更加普遍，包括孕妇。因此，最近的研究调查了产前使用大麻对儿童健康的潜在影响，结果不一。在本研究中，我们调查了州级大麻持有法律的放宽与两个表明儿童健康的出生结果之间的关系：出生体重和孕周。利用疾病控制与预防中心（CDC）的WONDER数据库、美国社区调查以及多个法律数据库2003 - 2019年的数据，我们使用固定效应模型来检验大麻政策的变化——从持有大麻为轻罪到非刑罪化再到合法化——如何影响出生体重和孕周的州级平均水平以及被归类为低出生体重（<2500克）和早产（<37周）的出生百分比。我们考虑了州级因素，包括医用大麻法律、健康相关政策、支出模式以及已知会影响健康的人口特征。结果表明，州级大麻持有法律的放宽与平均出生体重在统计学上显著降低相关，在较小程度上与孕周降低相关，对按年龄、种族/族裔以及包括慢性高血压和糖尿病在内的风险因素划分的女性亚组有显著影响。然而，我们没有发现大麻政策放宽后临床相关低出生体重或早产女性的百分比增加。尽管我们的研究没有显示不良出生结果有实质性变化，但政策制定者应关注通过考虑尽量减少准父母尤其是重度消费形式的消费的政策来加强儿童健康的机会。
