Objective We aimed to assess whether marijuana legalization was associated with a difference in prevalence of prenatal use or an increase in incidence of adverse perinatal outcomes.
Study Design The present study is a retrospective cohort of September and October deliveries in the years 2012 through 2015 at a tertiary center in Colorado. Primary outcome of the study was use of marijuana, defined by self-report or biodetection. Secondary outcomes of the study included growth restriction, spontaneous preterm birth, stillbirth, preeclampsia, and neonatal or maternal death. Marijuana use prevalence was compared by year, and secondary outcomes between two periods, before and after the opening of the first recreational dispensary.
Results A total of 2,392 pregnant women were included (1,165 before legalization and 1,227 after). More women used marijuana over the period of legalization (trend p = 0.01). Odds of marijuana use were higher after legalization versus before (adjusted odds ratio [aOR] = 1.8, 95% confidence interval [CI]: 1.2–2.6). Incidence of growth restriction was higher after legalization (2.9 vs. 5.1%, p = 0.0084). This difference persisted after adjustment for ethnicity and other drugs in multivariable modeling (aOR = 1.9, 95%CI: 1.2–3.0).
Conclusion The prevalence of prenatal marijuana use increased over the time of legalization. Further investigation into the population impact of legalization on obstetrical outcomes is warranted given the observed increase in growth restriction.
Data was retrieved from the medical center's perinatal database. A multi variable logistic regression model was used to find independent risk factors for stillbirth in our population. The ORs of chosen risk factors were compared between the time periods to assess the change trends of their specific contribution to the occurrence of stillbirth over the years. RESULTS: Within the investigated time period, 295,946 deliveries met the inclusion criteria. Of these, 2239 (0.75%) were stillborn. During the study period the incidence of stillbirth has not significantly changed and remained around 0.7%. A logistic regression model for the prediction of stillbirth found that lack of perinatal care, previous caesarian section and preeclampsia were independent risk factors for stillbirth (OR 1.85, 95% CI (1.64-2.10), P¼0.01; OR 1.36, 95% CI (1.21-1.52), P< 0.001; and OR 1.73, 95% CI (1.49-2.00), P< 0.001, respectively, Table). These risk factors demonstrated a negative linear trend with a significant decrease in their specific contribution to this grave outcome over the years (Figure). Other risk factors have shown changes with mixed trends (grandmultiparity and maternal age). CONCLUSION: In this study, several risk factors for stillbirth have shown a significantly decreasing contribution to the occurrence of stillbirth over the years. Other risk factors have shown changes with mixed trends. A better understanding of these changes might have a beneficial effect on our ability to predict this grave obstetrical outcome and improve maternal and neonatal care.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.