Additive drug-specific and sex-specific risks associated with co-use of marijuana and tobacco during pregnancy: Evidence from 3 recent developmental cohorts (2003–2015)

Massey, Suena H.; Mroczek, Daniel K.; Reiss, David; Jakubowski, Jessica A.; Graham, Eileen K; Shisler, Shannon; McCallum, Meaghan; Huestis, Marilyn A.; Ganiban, Jody M.; Shaw, Daniel S.; Leve, Leslie D.; Eiden, Rina D.; Stroud, Laura R.; Neiderhiser, Jenaè M.

doi:10.1016/j.ntt.2018.06.002

Cited by 19 publications

(8 citation statements)

References 76 publications

(97 reference statements)

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“…We found some evidence that the effects of prenatal cannabis use on spontaneous PTB and SGA were more pronounced in female infants. These results did not corroborate with previous research showing that in-utero cannabis exposure adversely affects male offspring but not female offspring with regards to LBW and is not associated with length of gestation [ 12 , 13 ]. However, previous research applied additive instead of multiplicative interactive effects which may account for the differences observed.…”

Section: Discussioncontrasting

confidence: 99%

“…Outcomes were chosen as key indicators of fetal growth and development, pregnancy complications and predictors of long term infant and maternal health. Gestational age at birth and birth weight are biomarkers of fetal neurodevelopmental risk [ 13 ], a key concern with prenatal cannabis exposure.…”

Section: Methodsmentioning

confidence: 99%

“…It is hypothesized that prenatal exposure to cannabis produces similar outcomes to tobacco by reducing blood flow to the placenta [6]. Limited research has reported that prenatal cannabis exposure adversely impacts neurodevelopment in male fetuses but not female fetuses through growth restriction [7][8][9][10][11][12][13]. Evidence suggests potential sex differences in the affinity of cannabinoid receptor 1 in the brain, the main target of Δ9-Tetrahydrocannabinol [12].…”

Section: Introductionmentioning

confidence: 99%

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Cannabis use in pregnancy and maternal and infant outcomes: A Canadian cross-jurisdictional population-based cohort study

Luke

Hobbs²,

Smith³

et al. 2022

PLoS ONE

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Background With the recent legalization of cannabis in Canada, there is an urgent need to understand the effect of cannabis use in pregnancy. Our population-based study investigated the effects of prenatal cannabis use on maternal and newborn outcomes, and modification by infant sex. Methods The cohort included 1,280,447 singleton births from the British Columbia Perinatal Data Registry, the Better Outcomes Registry & Network Ontario, and the Perinatal Program Newfoundland Labrador from April 1st, 2012 to March 31st, 2019. Logistic regression determined the associations between prenatal cannabis use and low birth weight, small-for-gestational age, large-for-gestational age, spontaneous and medically indicated preterm birth, very preterm birth, stillbirth, major congenital anomalies, caesarean section, gestational diabetes and gestational hypertension. Models were adjusted for other substance use, socio-demographic and-economic characteristics, co-morbidities. Interaction terms were included to investigate modification by infant sex. Results The prevalence of cannabis use in our cohort was approximately 2%. Prenatal cannabis use is associated with increased risks of spontaneous and medically indicated preterm birth (1.80[1.68–1.93] and 1.94[1.77–2.12], respectively), very preterm birth (1.73[1.48–2.02]), low birth weight (1.90[1.79–2.03]), small-for-gestational age (1.21[1.16–1.27]) and large-for-gestational age (1.06[1.01–1.12]), any major congenital anomaly (1.71[1.49–1.97]), caesarean section (1.13[1.09–1.17]), and gestational diabetes (1.32[1.23–1.42]). No association was found for stillbirth or gestational hypertension. Only small-for-gestational age (p = 0.03) and spontaneous preterm birth (p = 0.04) showed evidence of modification by infant sex. Conclusions Prenatal cannabis use increases the likelihood of preterm birth, low birth weight, small-for-gestational age and major congenital anomalies with prenatally exposed female infants showing evidence of increased susceptibility. Additional measures are needed to inform the public and providers of the inherent risks of cannabis exposure in pregnancy.

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Section: Discussioncontrasting

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cannabis use in pregnancy and maternal and infant outcomes: A Canadian cross-jurisdictional population-based cohort study

Luke

Hobbs²,

Smith³

et al. 2022

PLoS ONE

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“…Moreover, the association of early term birth with fine motor developmental delay was only detected in girls. Prior studies have shown that fetal gender may play an essential role in regulating the influence of prenatal exposure on neurodevelopment [41,42]. Male fetuses are more sensitive to early exposure to risk factors than female fetuses [43].…”

Section: Discussionmentioning

confidence: 99%

Impact of early term and late preterm birth on infants’ neurodevelopment: evidence from a cohort study in Wuhan, China

et al. 2022

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Background The incidences of early term and late preterm birth have increased worldwide during recent years. However, there is a lack of prospective study about the influence of early term and late preterm birth on infants’ neurodevelopment, especially at the early stage. Therefore, we conducted this cohort study to investigate the impact of early term and late preterm birth on infants’ neurodevelopment within 6 months. Methods This cohort study was conducted in Wuhan, China, between October 2012 and September 2013. A total of 4243 singleton infants born within 34-41 weeks of gestation at Wuhan Children’s Hospital were included. The Gesell Developmental Scale (GDS) was utilized to evaluate the neurodevelopment of infants. Results Among the 4243 included participants, 155 (3.65%) were late preterm infants, 1288 (30.36%) were early term infants, and 2800 (65.99%) were full term infants. After adjusted for potential confounders, significant negative relationship was shown between late preterm birth and development quotient (DQ) in all domains of neurodevelopment: gross motor (β = − 17.42, 95% CI: − 21.15 to − 13.69), fine motor (β = − 23.61, 95% CI: − 28.52 to − 18.69), adaptability (β = − 10.10, 95% CI: − 13.82 to − 6.38), language (β = − 6.28, 95% CI: − 9.82 to − 2.74) and social behavior (β = − 5.99, 95% CI: − 9.59 to − 2.39). There was a significant negative trend for early term birth in DQ of fine motor (β = − 2.01, 95% CI: − 3.93 to − 0.09). Late preterm infants had a significantly elevated risk of neurodevelopmental delay in domains of gross motor (adjusted OR = 3.82, 95% CI: 2.67 to 5.46), fine motor (adjusted OR = 3.51, 95% CI: 2.47 to 5.01), and adaptability (adjusted OR = 1.60, 95% CI: 1.12 to 2.29), whereas early term birth was significantly associated with neurodevelopmental delay of fine motor (adjusted OR = 1.22, 95% CI: 1.05 to 1.42). Conclusions This study suggested that late preterm birth mainly elevated the risk of neurodevelopmental delay of gross motor, fine motor, and adaptability, whereas early term birth was associated with the developmental delay of fine motor within 6 months. Further research is needed to determine the effectiveness and necessity of the interventions at the early stage for early term and late preterm infants who had suspected neurodevelopmental delay.

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“…The use of alcohol, tobacco and illicit drugs during pregnancy is a common source of pregnancy‐related morbidity in women and their infants . The reported rate of illicit drug use in Australian pregnant women varies greatly from 2.5% to 8% and may be grossly underestimated owing to self‐reporting .…”

Section: Pregnancy and Psychotropic Medicationsmentioning

confidence: 99%

Psychotropic medication use during pregnancy

Niethe

Whitfield

2018

Pharmacy Practice and Res

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Globally, mental health-related issues are a growing concern. Pregnant women with mental health-related illnesses present a unique challenge to health professionals. During pregnancy, the decision to withhold, modify or continue psychotropic medication requires consideration of both maternal and infant outcomes. Health professionals must be aware withdrawal of these medications during pregnancy can often lead to symptom relapse. Decisions around medication management during pregnancy can be challenging due to the lack of data and occasionally conflicting data regarding safety. It is essential that women do not receive conflicting information from health professionals because this can lead to confusion and both intentional and unintentional non-adherence. Recently, it has been suggested that pharmacists may help optimise medication management and patient outcomes in perinatal care. This review outlines the use of psychotropic medications in pregnancy and discusses key considerations for those involved in providing clinical care to pregnant women with mental illness.

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Additive drug-specific and sex-specific risks associated with co-use of marijuana and tobacco during pregnancy: Evidence from 3 recent developmental cohorts (2003–2015)

Cited by 19 publications

References 76 publications

Cannabis use in pregnancy and maternal and infant outcomes: A Canadian cross-jurisdictional population-based cohort study

Cannabis use in pregnancy and maternal and infant outcomes: A Canadian cross-jurisdictional population-based cohort study

Impact of early term and late preterm birth on infants’ neurodevelopment: evidence from a cohort study in Wuhan, China

Psychotropic medication use during pregnancy

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