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Medscape

Cannabis Use During Pregnancy Ups Adverse Birth Outcomes

Prenatal cannabis use was associated with 75% higher odds of low birth weight, 52% increased odds of preterm birth, and 57% greater odds of small for gestational age births. METHODOLOGY: Researchers conducted a systematic review and meta-analysis of 51 studies of over 21 million participants to analyze the association between people who used cannabis during pregnancy and the outcomes of their infants. The analysis included case-control studies of cannabis use during pregnancy against those with little to no cannabis use, adjusting for confounding factors such as tobacco use. Primary outcomes were preterm birth (< 37 weeks gestation), small for gestational age (< 10th percentile), low birth weight (< 2500 g), and death of an infant around the time of birth. Out of the studies used for the review, 24 were analyzed for low-birth-weight outcomes (n = 2,412,060), 42 were analyzed for preterm birth (n = 21,131,345), 21 were analyzed for small for gestational age (n = 7,816,179), and 6 were analyzed for perinatal mortality (n = 16,868,920). TAKEAWAY: Cannabis use during pregnancy was associated with a higher risk of giving birth to a low-weight infant (odds ratio [OR], 1.75; 95% CI, 1.41-2.18). Prenatal cannabis use was also linked to 1.52-fold higher odds of preterm birth and 1.57-fold higher odds of delivering a baby who was small for their gestational age. Meta-analysis of six studies found that cannabis use was linked to a higher risk for perinatal death (OR, 1.29; 95% CI, 1.07-1.55). IN PRACTICE: 'Our results may help guide patient counseling and harm reduction strategies and shape future public health policies focused on prenatal cannabis use,' the authors wrote. SOURCE: This study was led by Jamie O. Lo, MD, from the Department of Obstetrics and Gynecology at the Oregon Health and Science University in Portland, Oregon. It was published online on May 5 in JAMA Pediatrics . LIMITATIONS: This study did not include information on the mode of delivery, time of day, frequency, dosing strength, or duration of cannabis use during pregnancy. The researchers also could not account for severe nausea and vomiting during pregnancy, which can also increase the risk for low birth weight, preterm birth, and restriction of fetal growth. DISCLOSURES: The authors reported having no relevant financial disclosures.