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BJOG. 2019 Jul 23. doi: 10.1111/1471-0528.15885. [Epub ahead of print]

Marijuana use in young mothers and adverse pregnancy outcomes: a retrospective cohort study.

Author information

1
12631 E 17th Ave B198-6 Aurora, CO 80045 University of Colorado School of Medicine, Aurora, CO.
2
13001 E 17th Pl, Aurora, CO 80045 Colorado School of Public Health, Aurora, CO.
3
777 Bannock St, Denver, CO 80204 Denver Health and Hospital Authority, Denver, CO.

Abstract

OBJECTIVE:

Evaluate association between marijuana use and a composite adverse pregnancy outcome using biologic sampling.

DESIGN:

Retrospective cohort study.

SETTING:

Single tertiary center.

POPULATION:

Young women (13-22 years old) with singleton, non-anomalous pregnancies delivered September 2011- May 2017.

METHODS:

Exposure was defined as marijuana detected on universal urine toxicology testing or by self-report. Multivariable logistic regression modeling was used to estimate the effect of any marijuana use on the primary composite outcome. Effect of marijuana exposure also estimated for self-reported use, toxicology-detected use, and multiple toxicology-detected uses.

MAIN OUTCOME MEASURE:

Primary composite outcome included spontaneous preterm birth, hypertensive disorders of pregnancy, stillbirth, or small for gestational age.

RESULTS:

Of 1206 pregnant young women, 17.5% (n=211) used marijuana. Among the women who used marijuana, 8.5% (n=18) were identified by self-report alone, 63% (n=133) by urine-toxicology alone, and 28.4% (n=60) by both. Urine toxicology testing results were available for 1092 (90.5%) births. The composite outcome occurred more frequently in pregnancies exposed to marijuana (46 vs 34%, p<0.001). This remained significant after adjusting for race/ethnicity and tobacco in the multivariable model (aOR 1.50, 95% CI 1.09-2.05). When marijuana exposure was defined by self-report only, the association with the adverse pregnancy outcome became non-significant (aOR 1.01, 95% CI 0.62-1.64).

CONCLUSION:

In a population of young women with nearly universal biologic sampling, marijuana exposure was associated with adverse pregnancy outcomes. The observed heterogeneity of findings in existing studies evaluating the impact of marijuana on mothers and neonates may result from incomplete ascertainment of exposure. This article is protected by copyright. All rights reserved.

KEYWORDS:

THC ; Cannabis; Hypertensive Disorders of Pregnancy; Marijuana; Pregnancy; Preterm Birth; Small for Gestational Age; Stillbirth

PMID:
31334907
DOI:
10.1111/1471-0528.15885

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