Gretchen Bandoli1, Laura Jelliffe-Pawlowski2, Benjamin Schumacher3, Rebecca J Baer4, Jennifer N Felder5, Jonathan D Fuchs6, Scott P Oltman2, Martina A Steurer7, Carla Marienfeld8. 1. Department of Pediatrics, University of California San Diego, San Diego, CA, United States; Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, San Diego, CA, United States. Electronic address: gbandoli@ucsd.edu. 2. California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, United States; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States. 3. Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, San Diego, CA, United States. 4. Department of Pediatrics, University of California San Diego, San Diego, CA, United States; California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, United States; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States. 5. Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States; Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States. 6. California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, United States; San Francisco Department of Public Health, San Francisco, CA, United States. 7. California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, United States; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States; Department of Pediatrics, University of California San Francisco, San Francisco, CA, United States. 8. Department of Psychiatry, University of California San Diego, San Diego, CA, United States.
Abstract
BACKGROUND: Cannabis use and cannabis use disorders are increasing in prevalence, including among pregnant women. The objective was to evaluate the association of a cannabis-related diagnosis (CRD) in pregnancy and adverse maternal and infant outcomes. METHODS: We queried an administrative birth cohort of singleton deliveries in California between 2011-2017 linked to maternal and infant hospital discharge records. We classified pregnancies with CRD from International Classification of Disease codes. We identified nicotine and other substance-related diagnoses (SRD) in the same manner. Outcomes of interest included maternal (hypertensive disorders) and infant (prematurity, small for gestational age, NICU admission, major structural malformations) adverse outcomes. RESULTS: From 3,067,069 pregnancies resulting in live births, 29,112 (1.0 %) had a CRD. CRD was associated with an increased risk of all outcomes studied; the strongest risks observed were for very preterm birth (aRR 1.4, 95 % CI 1.3, 1.6) and small for gestational age (aRR 1.4, 95 % CI 1.3, 1.4). When analyzed with or without co-exposure diagnoses, CRD alone conferred increased risk for all outcomes compared to no use. The strongest effects were seen for CRD with other SRD (preterm birth aRR 2.3, 95 % CI 2.2, 2.5; very preterm birth aRR 2.6, 95 % CI 2.3, 3.0; gastrointestinal malformations aRR 2.0, 95 % CI 1.6, 2.6). The findings were generally robust to unmeasured confounding and misclassification analyses. CONCLUSIONS: CRD in pregnancy was associated with increased risk of adverse maternal and infant outcomes. Providing education and effective treatment for women with a CRD during prenatal care may improve maternal and infant health.
BACKGROUND: Cannabis use and cannabis use disorders are increasing in prevalence, including among pregnant women. The objective was to evaluate the association of a cannabis-related diagnosis (CRD) in pregnancy and adverse maternal and infant outcomes. METHODS: We queried an administrative birth cohort of singleton deliveries in California between 2011-2017 linked to maternal and infant hospital discharge records. We classified pregnancies with CRD from International Classification of Disease codes. We identified nicotine and other substance-related diagnoses (SRD) in the same manner. Outcomes of interest included maternal (hypertensive disorders) and infant (prematurity, small for gestational age, NICU admission, major structural malformations) adverse outcomes. RESULTS: From 3,067,069 pregnancies resulting in live births, 29,112 (1.0 %) had a CRD. CRD was associated with an increased risk of all outcomes studied; the strongest risks observed were for very preterm birth (aRR 1.4, 95 % CI 1.3, 1.6) and small for gestational age (aRR 1.4, 95 % CI 1.3, 1.4). When analyzed with or without co-exposure diagnoses, CRD alone conferred increased risk for all outcomes compared to no use. The strongest effects were seen for CRD with other SRD (preterm birth aRR 2.3, 95 % CI 2.2, 2.5; very preterm birth aRR 2.6, 95 % CI 2.3, 3.0; gastrointestinal malformations aRR 2.0, 95 % CI 1.6, 2.6). The findings were generally robust to unmeasured confounding and misclassification analyses. CONCLUSIONS: CRD in pregnancy was associated with increased risk of adverse maternal and infant outcomes. Providing education and effective treatment for women with a CRD during prenatal care may improve maternal and infant health.
Authors: Sarah E Paul; Alexander S Hatoum; Jeremy D Fine; Emma C Johnson; Isabella Hansen; Nicole R Karcher; Allison L Moreau; Erin Bondy; Yueyue Qu; Ebony B Carter; Cynthia E Rogers; Arpana Agrawal; Deanna M Barch; Ryan Bogdan Journal: JAMA Psychiatry Date: 2021-01-01 Impact factor: 25.911
Authors: Drayton C Harvey; Rebecca J Baer; Gretchen Bandoli; Christina D Chambers; Laura L Jelliffe-Pawlowski; S Ram Kumar Journal: J Am Heart Assoc Date: 2022-01-11 Impact factor: 6.106