BJOG An International Journal of Obstetrics & Gynaecology,
Год журнала:
2024,
Номер
unknown
Опубликована: Ноя. 25, 2024
ABSTRACT
Objective
We
tested
for
the
potential
associations
between
maternal
antenatal
cannabis
use
disorders
(CUD)
and
neonatal
health
outcomes
using
large
linked
administrative
data.
Design
Population‐based
retrospective
cohort
study.
Setting
The
study
was
conducted
in
New
South
Wales,
Australia.
Population
or
Sample
A
total
of
215
879
singleton
live
births.
Methods
Generalised
linear
models
(GLMs)
fitted
log‐binomial
regression
to
estimate
risk
ratios
(RRs)
with
corresponding
95%
confidence
intervals
(95%
CI).
Additionally,
we
a
propensity
score
matching
(PSM)
analysis.
Main
Outcome
Measures
include
preterm
births
(PTB),
low
birth
weight
(LBW),
small
gestational
age
(SGA),
5‐min
lower
Apgar
scores
admission
intensive
care
unit
(NICU).
Results
In
unmatched
analyses,
CUD
associated
increased
risks
all
adverse
(adjusted
ratio
[RR]
ranging
from
1.47
[95%
CI:
1.01,
2.14]
APGAR
2.58
CI
2.28,
2.91]
PTB).
PSM
observed
slightly
attenuated
PTB
(RR
=
1.98
[1.70,
2.31]),
LBW
2.46
[2.13,
2.84]),
SGA
1.84
[1.44,
2.35])
NICU
1.91
[1.49,
2.45])
after
by
covariates.
However,
found
no
significant
association
[0.94,
2.30]).
Conclusion
that
exposure
is
range
outcomes.
This
highlights
targeted
interventions
focusing
on
counselling
are
recommended
mitigate
use.
International Journal of Drug Policy,
Год журнала:
2021,
Номер
99, С. 103381 - 103381
Опубликована: Авг. 28, 2021
Cannabis
use
is
common,
especially
among
young
people,
and
associated
with
risks
for
various
health
harms.
Some
jurisdictions
have
recently
moved
to
legalization/regulation
pursuing
public
goals.
Evidence-based
'Lower
Risk
Use
Guidelines'
(LRCUG)
recommendations
were
previously
developed
reduce
modifiable
risk
factors
of
cannabis-related
adverse
outcomes;
related
evidence
has
evolved
substantially
since.
We
aimed
review
new
scientific
develop
comprehensively
up-to-date
LRCUG,
including
their
recommendations,
on
this
basis.
Targeted
searches
literature
(since
2016)
main
outcomes
by
the
user-individual
conducted.
Topical
areas
informed
previous
LRCUG
content
expanded
upon
current
evidence.
Searches
preferentially
focused
systematic
reviews,
supplemented
key
individual
studies.
The
results
evidence-graded,
topically
organized
narratively
summarized;
through
an
iterative
expert
consensus
development
process.
A
substantial
body
cannabis
use-related
harms
identified
varying
quality.
Twelve
substantive
recommendation
clusters
three
precautionary
statements
developed.
In
general,
suggests
that
individuals
can
if
they
delay
onset
until
after
adolescence,
avoid
high-potency
(THC)
products
high-frequency/-intensity
use,
refrain
from
smoking-routes
administration.
While
people
are
particularly
vulnerable
harms,
other
sub-groups
(e.g.,
pregnant
women,
drivers,
older
adults,
those
co-morbidities)
advised
exercise
particular
caution
risks.
Legal/regulated
should
be
used
where
possible.
result
in
outcomes,
mostly
higher-risk
use.
Reducing
help
offer
one
targeted
intervention
component
within
a
comprehensive
approach
They
require
effective
audience-tailoring
dissemination,
regular
updating
as
become
available,
evaluated
impact.
JAMA Network Open,
Год журнала:
2024,
Номер
7(5), С. e2410151 - e2410151
Опубликована: Май 7, 2024
Importance
The
prevalence
of
cannabis
use
in
pregnancy
is
rising
and
associated
with
adverse
perinatal
outcomes.
In
parallel,
combined
prenatal
nicotine
also
increasing,
but
little
known
about
the
impact
both
substances
on
offspring
outcomes
compared
each
substance
alone.
Objective
To
assess
exposure
alone
during
pregnancy.
Design,
Setting,
Participants
This
retrospective
population-based
cohort
study
included
linked
hospital
discharge
data
(obtained
from
California
Department
Health
Care
Access
Information)
vital
statistics
Public
Health)
January
1,
2012,
through
December
31,
2019.
Pregnant
individuals
singleton
gestations
gestational
ages
23
to
42
weeks
were
included.
Data
analyzed
October
14,
2023,
March
4,
2024.
Exposures
Cannabis-related
diagnosis
product
captured
using
codes
International
Classification
Diseases,
Ninth
Revision,
Clinical
Modification
,
Statistical
Tenth
.
Main
Outcome
Measures
main
infant
neonatal
death,
infants
small
for
age,
preterm
delivery.
Results
by
multivariable
Poisson
regression
models.
A
total
3
129
259
pregnant
(mean
[SD]
maternal
age
29.3
[6.0]
years),
whom
007
(0.7%)
had
a
cannabis-related
diagnosis,
56
811
(1.8%)
nicotine-use
10
312
(0.3%)
Compared
nonusers,
those
or
diagnoses
increased
rates
(0.7%
both)
(0.3%
(14.3%
13.7%,
respectively),
delivery
(<37
weeks)
(12.2%
12.0%,
respectively).
Moreover,
risks
higher
death
(1.2%;
adjusted
risk
ratio
[ARR],
2.18
[95%
CI,
1.82-2.62]),
(0.6%;
ARR,
1.76
1.36-2.28]),
(18.0%;
1.94
1.86-2.02]),
(17.5%;
1.83
1.75-1.91]).
Conclusions
Relevance
These
findings
suggest
that
co-occurring
products
an
morbidity
either
Given
increasing
pregnancy,
these
can
help
guide
health
care
practitioners
preconception
counseling,
especially
regarding
benefits
cessation.
American Journal of Perinatology,
Год журнала:
2022,
Номер
41(01), С. 017 - 030
Опубликована: Июль 28, 2022
Objective
Our
objective
was
to
summarize
the
literature
regarding
effects
of
cannabis
use
during
pregnancy
on
low
birth
weight
(LBW),
preterm
(PTB),
and
small
for
gestational
age
(SGA).
Study
Design
This
is
a
systematic
review
meta-analysis.
A
search
conducted
in
PubMed,
Scopus,
EBSCO,
Web
Science
May
2021
updated
November
2021.
Only
studies
that
assessed
isolated
pregnancy,
controlling
cigarette
smoking,
other
illicit
drug
were
included.
Data
synthesized
using
narrative
summary
pooled
adjusted
estimates,
95%
confidence
intervals
(CIs)
calculated
each
outcome.
analyzed
Stata
13.0
with
METAN
software
package,
random
effects.
Statistical
heterogeneity
Cochran's
Q
Higgins
I2
tests.
Results
In
total,
32
included
data
from
approximately
5.5
million
women
LBW
outcome
23
PTB
SGA
outcomes.
Pregnant
are
at
increased
risk
(adjusted
odds
ratio
[aOR]
=
1.52;
CI
[1.18;
1.96]),
(aOR
1.39;
[1.28;
1.51]),
1.47;
[1.38;
1.58]).
Studies
type
indicate
higher
risks
spontaneous
early
or
very-early
PTBs
associated
pregnancy.
The
few
timing
frequency
consumption
suggest
dose–response
effect,
negative
outcomes
among
who
reported
heavy
continued
second
third
trimesters
gestation.
Conclusion
There
an
effect
irrespective
drugs
tobacco
despite
high
quality
evidence.
need
discuss
public
policies
cannabis'
regulation
how
it
influences
its
consumption.
Future
should
focus
cannabis's
(medicinal
recreational),
timing,
dosage
perinatal
Key
Points
Obstetrics and Gynecology,
Год журнала:
2023,
Номер
unknown
Опубликована: Авг. 10, 2023
OBJECTIVE:
To
understand
pregnant
patients'
reasons
for
prenatal
cannabis
use
and
perceptions
of
safety,
desired
undesirable
health
care
experiences,
information
about
secondarily
to
racial
differences
in
these
preferences.
METHODS:
We
conducted
a
qualitative
study
including
18
semi-structured,
race-concordant
virtual
focus
groups
with
individuals
who
self-reported
at
entry
large
integrated
system
Northern
California
from
November
2021
December
2021.
The
included
semi-structured
questions
that
were
recorded,
transcribed,
coded
by
the
research
team.
Thematic
analysis
was
used
analyze
data.
RESULTS:
Overall,
53
participants
included;
30
self-identified,
as
White
23
self-identified
Black.
Participants
averaged
30.3
years
age
(SD
5.2
years)
on
average
20.9
weeks
gestation
enrollment;
69.8%
reported
daily
use,
24.5%
weekly
5.7%
monthly
or
less
entrance
care.
Although
some
quit
early
pregnancy
because
concerns
potential
risks,
many
perceived
lack
scientific
evidence
believed
safe.
Many
preferred
over-the-counter
prescription
medications
treating
mood,
morning
sickness,
pain,
sleep.
valued
open
interactions
obstetricians
acknowledged
their
motivations
they
risks
through
conversations
educational
materials.
Black
participants'
perspectives
generally
similar,
but
few
uniquely
described
bias
related
use.
CONCLUSION:
Pregnant
patients
manage
mood
medical
symptoms,
safer
than
medications.
Obstetrician-initiated,
patient-centered
around
advice
discontinue
during
pregnancy,
exploration
willingness
switch
medically
recommended
interventions
pregnancy-related
symptoms
may
benefit
patients.
Journal of Dual Diagnosis,
Год журнала:
2023,
Номер
19(2-3), С. 71 - 96
Опубликована: Июль 3, 2023
Objective:
Cannabis
use
is
increasingly
normalized;
psychosis
a
major
adverse
health
outcome.
We
reviewed
evidence
on
cannabis
use-related
risk
factors
for
outcomes
at
different
stages
toward
recommendations
reduction
by
individuals
involved
in
use.
Methods:
searched
primary
databases
pertinent
literature/data
2016
onward,
principally
relying
reviews
and
high-quality
studies
which
were
narratively
summarized
quality-graded;
developed
international
expert
consensus.
Results:
Genetic
risks,
mental
health/substance
problem
histories
elevate
the
risks
cannabis-related
psychosis.
Early
age-of-use-onset,
frequency-of-use,
product
composition
(i.e.,
THC
potency),
mode
other
substance
co-use
all
influence
risks;
protective
effects
of
CBD
are
uncertain.
Continuous
may
adversely
affect
psychosis-related
treatment
medication
effects.
Risk
factor
combinations
further
amplify
odds
outcomes.
Conclusions:
Reductions
identified
factors—short
abstinence—may
decrease
related
outcomes,
thereby
protect
users'
health.
Journal of Perinatology,
Год журнала:
2023,
Номер
43(4), С. 477 - 483
Опубликована: Март 13, 2023
Abstract
Objective
Whether
psychosocial
adversity
during
pregnancy
impacts
fetal
health
outcomes
at
birth
remains
underexplored.
This
is
a
critical
issue
given
significant
social
disadvantage
and
stress
faced
by
pregnant
women
worldwide.
Study
design
Measures
of
psychological
factors,
medical/reproductive
nutritional
status
in
were
obtained
each
trimester.
Using
Structural
Equation
Modeling
(SEM),
we
investigated
the
relationship
forms
to
other
infant
gestational
age,
birthweight.
Results
Among
399
singletons,
Social
Disadvantage
significantly
predicted
age
(
p
=
0.003),
residual
birthweight
0.006).
There
was
0.4
week
decrease
3%
for
standard
deviation
increase
Disadvantage.
Conclusion
Significant
negative
effects
on
developing
fetus
found.
Notably,
these
emerged
despite
good
prenatal
care
after
accounting
maternal
medical
reproductive
risk
factors.
Obstetrical & Gynecological Survey,
Год журнала:
2023,
Номер
78(7), С. 411 - 428
Опубликована: Июль 1, 2023
Importance
Prenatal
cannabis
use
is
rising
and
a
major
public
health
issue.
Cannabis
in
pregnancy
during
lactation
has
been
associated
with
increased
maternal
offspring
morbidity
mortality.
Objective
This
review
aims
to
summarize
the
existing
literature
current
recommendations
for
or
lactation.
Evidence
Acquisition
A
PubMed,
Cochrane
Library,
Google
Scholar
search
using
following
terms
was
performed
gather
relevant
data:
“cannabis,”
“cannabinoid,”
“delta-9-tetrahydrocannabinol,”
“THC,”
“cannabidiol,”
“fetal
outcomes,”
“perinatal
“pregnancy,”
“lactation.”
Results
Available
studies
on
were
reviewed
support
an
association
risk
of
preterm
birth,
neonatal
intensive
care
unit
admission,
low
birth
weight,
small-for-gestational-age
infants.
Conclusion
Relevance
There
critical
need
research
effects
necessary
first
step
before
furthering
patient
education,
developing
interventions,
targeting
antenatal
surveillance
ameliorate
adverse
impacts
fetal
health.
Target
Audience
Obstetricians
gynecologists,
family
physicians,
pediatricians
Learning
Objectives
After
participating
this
activity,
learner
should
be
better
able
describe
options
treatment
disorder;
explain
common
forms
cannabinoids
available
use;
discuss
screening
pregnancy.
Current Obesity Reports,
Год журнала:
2024,
Номер
13(1), С. 154 - 166
Опубликована: Янв. 3, 2024
Abstract
Purpose
of
Review
To
consolidate
information
on
the
obesogenic
and
cardiometabolic
effects
prenatal
exposure
to
cannabis.
Recent
Findings
A
PubMed
search
strategy
updated
from
January
1,
2014,
through
14
June
2023,
produced
a
total
47
epidemiologic
studies
12
animal
studies.
Prenatal
cannabis
is
consistently
associated
with
small
for
gestational
age
low
birth
weight.
After
birth,
these
offspring
gain
weight
rapidly
have
increased
adiposity
higher
glucose
(fat
mass
percentage)
in
childhood.
More
preclinical
prospective
are
needed
deepen
our
understanding
whether
associations
vary
by
sex,
dose,
timing,
composition
(e.g.,
ratio
delta-Δ9-tetrahydrocannabinol
[Δ9-THC]
cannabidiol
[CBD]).
Addressing
gaps
may
help
solidify
causality
identify
intervention
strategies.
Summary
Based
available
data,
clinicians
public
health
officials
should
continue
caution
against
use
during
pregnancy
limit
its
potential
adverse
offspring.