Effects of Maternal Marijuana and Cocaine Use on Fetal Growth

Zuckerman, Barry; Frank, Deborah A.; Hingson, Ralph; Amaro, Hortensia; Levenson, Suzette; Kayne, Herbert L.; Parker, Steven J.; Vinci, Robert J.; Aboagye, Kwabena; Fried, Lise E.; Cabral, Howard; Timperi, Ralph; Bauchner, Howard

doi:10.1056/nejm198903233201203

Cited by 767 publications

(160 citation statements)

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“…Heavier prenatal marijuana exposure was associated with lower height z score but higher weight for height z score. While few long-term studies of growth outcomes of prenatally marijuanaexposed children exist, data collected at birth indicate a significantly lower birth length [41].…”

Section: Discussionmentioning

confidence: 99%

“…Related to fetal growth however, there are consistent findings indicating that after consideration of a large number of covariates, prenatal cocaine exposure has specific effects on infant birth parameters including head circumference, weight and length [4,5,9,11,12,31,37,41]. Growth deficits are believed to result from poor maternal nutrition, restricted placental blood flow or some other unknown mechanism.…”

Section: Introductionmentioning

confidence: 99%

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Dysmorphic and anthropometric outcomes in 6-year-old prenatally cocaine-exposed children

Minnes

Robin

Alt

et al. 2006

Neurotoxicology and Teratology

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Dysmorphologic and anthropometric assessments were performed on 154 6-year-old children prenatally exposed to cocaine (PCE) and 131 high-risk controls (NCE) of similar race and social class. Adjusted mean height z scores demonstrated a dose-response with metahydroxybenzoylecgonine above a threshold of 100 ng/g of meconium and greater cocaine exposure predicted lower weight for height z score. Higher average alcohol exposure throughout pregnancy and 3rd trimester predicted lower head circumference and weight z scores, respectively. Severity of marijuana use also predicted lower height for age but greater weight for height. There was not an increased rate of minor anomalies among the PCE cohort, nor was a consistent phenotype identified. After controlling for covariates, higher average prenatal cigarette exposure predicted higher incidence of cranial facial abnormalities. First trimester alcohol exposure predicted greater rates of ear abnormalities and third trimester marijuana exposure predicted greater rates of chest and head shape abnormalities. These finding indicate that prenatal cocaine exposure has a negative effect on specific growth outcomes including standardized height and weight for height, but not a systematic pattern of structural abnormalities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dysmorphic and anthropometric outcomes in 6-year-old prenatally cocaine-exposed children

Minnes

Robin

Alt

et al. 2006

Neurotoxicology and Teratology

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“…It is suggested that the active ingredient of cannabis, tetrahydrocannabinol, crosses the placental barrier and directly affects the fetus. Persistent use of cannabis may result in decreased uteroplacental perfusion and intrauterine fetal growth restriction (4). Previous research linking antenatal cannabis use and adverse pregnancy outcomes has been inconclusive (5).…”

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confidence: 99%

Birth outcomes associated with cannabis use before and during pregnancy

et al. 2011

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Articles Clinical Investigationnature publishing group INTRODUCTION:This study aimed to examine the association between cannabis use before and during pregnancy and birth outcomes. RESULTS: Overall, 26.3% of women reported previous use of cannabis and 2.6% reported current use. Multivariate analysis, controlling for potential confounders, including tobacco smoking, alcohol consumption, and use of other illicit drugs, showed that cannabis use in pregnancy was associated with low birth weight (odds ratio (OR) = 1.7; 95% confidence interval (cI): 1.3-2.2), preterm labor (OR = 1.5; 95% cI: 1.1-1.9), small for gestational age (OR = 2.2; 95% cI: 1.8-2.7), and admission to the neonatal intensive care unit (OR = 2.0; 95% cI: 1.7-2.4). DISCUSSION:The results of this study show that the use of cannabis in pregnancy is associated with increased risk of adverse birth outcomes. Prevention programs that address cannabis use during pregnancy are needed. METHODS: Data were from women birthing at the Mater Mothers' hospital in Brisbane, australia, over a 7-y period (2000)(2001)(2002)(2003)(2004)(2005)(2006). Women were interviewed in the initial antenatal visit about their use of cannabis and other substances. Records for 24,874 women who provided information about cannabis use, and for whom birth outcomes data were available, were included in the analysis.

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“…[1][2][3][4][5] One study concluded that exposure to cocaine and marijuana did not alter neonatal body proportionality. 4 Another study found that head circumferences of cocaine exposed newborns were relatively smaller than would be expected at a given birth weight.…”

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confidence: 99%

Dose-Response Effect of Cocaine on Newborn Head Circumference

Bateman

Chiriboga

2000

Pediatrics

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ABSTRACT. Objective. To evaluate the relationship between head circumference, birth weight, and cocaine dose in healthy term and near-term newborns exposed to cocaine in utero.Methods. We used radioimmune assay (RIAH) of cocaine metabolite in maternal hair to quantify third trimester cocaine exposure in 240 healthy newborn infants (gestational age: >36 weeks). Cocaine exposure was categorized into 3 levels: no exposure (n ‫؍‬ 136), low cocaine exposure (n ‫؍‬ 52; RIAH: 2-66 ng/10 mg hair), and high cocaine exposure (n ‫؍‬ 52; RIAH: 81-4457 ng/10 mg hair). We collected information on maternal demographic characteristics, the pregnancy, and the use of substances through a structured interview and from the medical record.Results. Means of birth weight, length, and head circumference of infants with high cocaine exposure differed significantly from those with low exposure and no exposure, but were similar between low exposure and no exposure. We used a multiple linear regression model to assess the association between newborn head circumference and cocaine level, adjusting for the effects of birth weight; gestational age; infant sex; and several maternal factors, including height, weight gain during pregnancy, syphilis during pregnancy, and the use of alcohol, cigarettes, marijuana, and opiates during pregnancy. Only birth weight, sex, and high cocaine exposure were significantly associated with newborn head circumference. The predicted head circumference deficit associated with high cocaine exposure (.44 cm) represents 34% of the unadjusted difference (1.28 cm) between mean head circumferences of infants in the high cocaine exposure and no exposure groups.Conclusion. Newborns exposed to a high level of cocaine in utero (RIAH: >81 ng/10 mg hair) exhibit asymmetric intrauterine growth retardation in which the head circumference is disproportionately smaller than would be predicted from the birth weight (head wasting). The deficit in head size associated with cocaine exposure may reflect the effects of a specific central nervous system insult that interferes with prenatal brain growth. Pediatrics 2000;106(3). URL: http://www.pediatrics.org/ cgi/content/full/106/3/e33; cocaine, infant, newborn, fetal development, head.ABBREVIATIONS. RIAH, radioimmune assay; SE, standard error; PCP, phencyclidine; OR, odds ratio. S everal observational studies have found an association between intrauterine cocaine exposure and diminished fetal growth, but the nature of the relationship between head and body size of exposed newborns remains unclear. 1-5 One study concluded that exposure to cocaine and marijuana did not alter neonatal body proportionality. 4 Another study found that head circumferences of cocaine exposed newborns were relatively smaller than would be expected at a given birth weight. 6 Also unclear is the relationship between cocaine dose and head circumference. Two studies found that head circumference decreased with increasing cocaine dose, but this relationship was not adjusted for birth weight or the influence of othe...

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Effects of Maternal Marijuana and Cocaine Use on Fetal Growth

Cited by 767 publications

References 24 publications

Dysmorphic and anthropometric outcomes in 6-year-old prenatally cocaine-exposed children

Dysmorphic and anthropometric outcomes in 6-year-old prenatally cocaine-exposed children

Birth outcomes associated with cannabis use before and during pregnancy

Dose-Response Effect of Cocaine on Newborn Head Circumference

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