Robinson Tessa, Fischer Benedikt, Hautala Rebecca, Bertram Mavoy, Ali Muhammad Usman, Farrokhyar Forough, Jack Susan, Kapiriri Lydia
Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Research and Graduate Studies, University of the Fraser Valley, Abbotsford, BC, Canada.
Syst Rev. 2024 Dec 19;13(1):307. doi: 10.1186/s13643-024-02718-7.
Cannabis use during pregnancy has been increasing and is associated with adverse neonatal outcomes, such as low birth weight (LBW) and preterm birth (PTB). It remains largely unknown whether the association between cannabis use in pregnancy and increased risk of adverse neonatal outcomes is impacted by the frequency of cannabis use and whether thresholds exist below which risk is not significantly increased. The objective of this systematic review is to assess whether the association between cannabis use during pregnancy and the risk of adverse neonatal outcomes is dependent on the frequency of use and whether risk thresholds exist.
For this systematic review and dose-response meta-analysis, the Embase, MEDLINE, PsycINFO, CINAHL, and Web of Science databases will be searched for relevant studies published in English from January 2010 onwards. Studies that include pregnant individuals with singleton pregnancies and evaluate the association between cannabis use in pregnancy and adverse neonatal outcomes using case-control, cohort, or cross-sectional designs will be considered for inclusion. Studies must include information on cannabis use frequency reported according to at least three of the pre-defined categories of no use, yearly (1-11 days per year), monthly (1-3 days per month), weekly (1-4 days per week), and daily/near daily use (5-7 days per week). At least one of the following neonatal outcomes must be reported, according to the frequency of cannabis use: LBW (< 1500 g), PTB (before 37 weeks gestation), neonatal intensive care unit (NICU) admission, and mortality. Studies will be included that report results as risk ratios (RR), odds ratios (OR), hazard ratios (HR), or that include the raw data to be able to calculate them. A two-stage dose-response meta-analysis will be conducted. The risk of bias of included studies will be assessed using the JBI tools for cohort, case-control, and cross-sectional studies. Certainty of the evidence will be reported according to the GRADE approach and the review will be reported according to PRISMA guidelines.
The frequency of cannabis is one factor that may influence the relationship between cannabis use in pregnancy and adverse neonatal outcomes. This review will quantify this relationship by determining whether risk thresholds exist.
PROSPERO CRD42023479978.
孕期使用大麻的情况一直在增加，且与不良新生儿结局相关，如低出生体重（LBW）和早产（PTB）。孕期使用大麻与不良新生儿结局风险增加之间的关联是否受大麻使用频率的影响，以及是否存在风险不显著增加的阈值，目前仍 largely 未知。本系统评价的目的是评估孕期使用大麻与不良新生儿结局风险之间的关联是否取决于使用频率，以及是否存在风险阈值。
对于本系统评价和剂量反应荟萃分析，将检索 Embase、MEDLINE、PsycINFO、CINAHL 和 Web of Science 数据库，以查找 2010 年 1 月起发表的英文相关研究。纳入的研究需包括单胎妊娠的孕妇，并采用病例对照、队列或横断面设计评估孕期使用大麻与不良新生儿结局之间的关联。研究必须包括根据预定义的至少三类使用频率报告的大麻使用信息，即不使用、每年（每年 1 - 11 天）、每月（每月 1 - 3 天）、每周（每周 1 - 4 天）以及每日/近乎每日使用（每周 5 - 7 天）。根据大麻使用频率，必须报告以下至少一项新生儿结局：低出生体重（<1500 克）、早产（妊娠 37 周前）、新生儿重症监护病房（NICU）入院以及死亡率。纳入的研究需报告风险比（RR）、比值比（OR）、风险比（HR）结果，或包含能够计算这些结果的原始数据。将进行两阶段剂量反应荟萃分析。使用 JBI 队列、病例对照和横断面研究工具评估纳入研究的偏倚风险。将根据 GRADE 方法报告证据的确定性，并按照 PRISMA 指南报告本评价。
大麻使用频率是可能影响孕期使用大麻与不良新生儿结局之间关系的一个因素。本评价将通过确定是否存在风险阈值来量化这种关系。
PROSPERO CRD42023479978。
