Objectives

To examine the association of prenatal cannabis use and adverse infant outcomes in a nationally representative cohort and consider the impact of concurrent cigarette exposure.

Study design

We conducted a retrospective cohort study on 32 583 new mothers from the 2017-2019 Pregnancy Risk Assessment Monitoring System. Cannabis use was evaluated as a binary variable (use or no use) as well as ordinal categories (no, light, moderate, heavy use). We used multivariable logistic regression to examine the relationship between prenatal cannabis exposure and low birthweight (LBW), preterm birth, and small for gestational age.

Results

Prenatal cannabis use was associated with significantly greater odds of LBW (aOR, 1.27; 95% CI, 1.05-1.54) and small for gestational age (aOR, 1.35; 95% CI, 1.09-1.68) but not preterm birth. Compared with nonusers, heavy users (weekly or more) were twice as likely to deliver a LBW infant (aOR, 2.07; 95% CI, 1.46-2.94) or small for gestational age infant (aOR, 2.14; 95% CI, 1.38-3.30). When examining combined cannabis and cigarette use, prenatal exposure to both substances increased the likelihood of LBW (aOR, 2.27; 95% CI, 1.71-3.01), preterm birth (aOR, 1.61; 95% CI, 1.12-2.31), and small for gestational age (aOR, 3.29; 95% CI, 2.39-4.55) compared with no use, and the increased odds were greater than for either substance alone.

Conclusions

Our results suggest that cannabis use during pregnancy may harm fetal development, and recommendations to improve birth outcomes should address co-use of cannabis and tobacco.

中文翻译：

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妊娠风险评估监测系统中的产前大麻使用和婴儿出生结果

目标

在具有全国代表性的队列中检查产前大麻使用与婴儿不良结局之间的关系，并考虑同时接触香烟的影响。

学习规划

我们对来自 2017-2019 年妊娠风险评估监测系统的 32 583 名新妈妈进行了回顾性队列研究。大麻的使用被评估为一个二元变量（使用或不使用）以及序数类别（不使用、轻度、中度、重度使用）。我们使用多变量逻辑回归来检查产前大麻暴露与低出生体重 (LBW)、早产和小于胎龄儿之间的关系。

结果

产前使用大麻与 LBW（aOR，1.27；95% CI，1.05-1.54）和小于胎龄（aOR，1.35；95% CI，1.09-1.68）的几率显着增加有关，但与早产无关。与非使用者相比，重度使用者（每周或更多）分娩 LBW 婴儿（aOR，2.07；95% CI，1.46-2.94）或小于胎龄婴儿（aOR，2.14；95% CI，1.38- 3.30）。在检查大麻和香烟的组合使用情况时，产前接触这两种物质会增加 LBW（aOR，2.27；95% CI，1.71-3.01）、早产（aOR，1.61；95% CI，1.12-2.31）和小体重的可能性胎龄（aOR，3.29；95% CI，2.39-4.55）与不使用相比，增加的几率大于单独使用任何一种物质。

结论

我们的研究结果表明，怀孕期间使用大麻可能会损害胎儿发育，改善出生结局的建议应解决大麻和烟草的共同使用问题。