Bailey Anna, Kerr Whitney, Alhay Zahra, Rom Morgan, Hamilton Sheryl, Campbell Janis, Kuhn Katrin, Thompson David, Reese Jessica A
Department of Biostatistics and Epidemiology, Center for American Indian Health Research, Hudson College of Public Health, University of Oklahoma Health Sciences Center, 801 NE 13Th Street, Room 372, Oklahoma City, OK, 73104, USA.
Department of Health Promotion Sciences, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Matern Child Health J. 2025 May;29(5):703-713. doi: 10.1007/s10995-025-04096-5. Epub 2025 May 3.
Current literature addressing fetal cannabis exposure and neonatal outcomes is based on subjective measures with varying levels of significance. This systematic review and meta-analysis determined if neonates with fetal cannabis exposure have an increased odds of being born small for gestational age, low birth weight, admitted to the Neonatal Intensive Care Unit (NICU) immediately after delivery, and/or preterm.
To identify relevant articles, we searched five databases using standard search criteria. Two authors used the Newcastle-Ottawa Scale to exclude articles with a high risk of bias. To estimate the combined effect, we calculated pooled odd ratios (OR) with 95% confidence intervals (CI) using the Mantel-Haenszel method for dichotomous data.
Of 3,390 original articles we identified through the search strategy, 13 met the inclusion criteria. This meta-analysis indicates that neonates with fetal cannabis exposure have higher odds of being small for gestational age (OR = 1.79; 95% CI = 1.24-2.59) and/or having a low birth weight (OR = 1.38; 95% CI = 1.05-1.89) compared to neonates without fetal cannabis exposure. The results regarding NICU admission and preterm birth were statistically inconclusive (NICU admission: OR = 1.38, 95% CI = 0.86-2.22; Preterm birth: OR = 1.29, 95% CI = 0.97-1.71). Although the odds ratios for these associations span one suggesting a null relationship, they have an upper bound that may be clinically relevant.
Based on these findings, further research, as well as an evaluation of the current public health response, is warranted. Additional research is needed to identify the association between neonatal outcomes and specific nuances of fetal cannabis exposure, such as route of ingestion, frequency of use, dose consumed, and the timing of intrauterine exposure.
目前关于胎儿接触大麻及其新生儿结局的文献基于具有不同显著水平的主观测量方法。本系统综述和荟萃分析旨在确定胎儿接触大麻的新生儿出生时小于胎龄、低出生体重、出生后立即入住新生儿重症监护病房（NICU）和/或早产的几率是否增加。
为识别相关文章，我们使用标准检索标准在五个数据库中进行检索。两位作者使用纽卡斯尔-渥太华量表排除偏倚风险高的文章。为估计合并效应，我们使用曼特尔-亨泽尔法对二分数据计算合并比值比（OR）及95%置信区间（CI）。
通过检索策略我们共识别出3390篇原始文章，其中13篇符合纳入标准。该荟萃分析表明，与未接触大麻的新生儿相比，接触大麻的新生儿出生时小于胎龄（OR = 1.79；95% CI = 1.24 - 2.59）和/或低出生体重（OR = 1.38；95% CI = 1.05 - 1.89）的几率更高。关于入住NICU和早产的结果在统计学上无定论（入住NICU：OR = 1.38，95% CI = 0.86 - 2.22；早产：OR = 1.29，95% CI = 0.97 - 1.71）。尽管这些关联的比值比范围表明可能存在无关联关系，但它们的上限可能具有临床相关性。
基于这些发现，有必要进行进一步研究以及对当前公共卫生应对措施进行评估。需要更多研究来确定新生儿结局与胎儿接触大麻的特定细微差别之间的关联，例如摄入途径、使用频率、摄入量以及宫内接触时间。
