Prevalence and associated birth outcomes of co-use of Cannabis and tobacco cigarettes during pregnancy

Abstract

Use of Cannabis and use of tobacco overlap, and co-use of Cannabis and tobacco has increased over the past decade among adults. The current study aims to document the prevalence and correlates of co-use of Cannabis and tobacco cigarettes among adult pregnant women utilizing secondary data from a larger study that compared and validated screeners for illicit and prescription drug use during pregnancy. Pregnant women (N = 500; 71% African American; 65% never married, average age of 28 years) were recruited from two urban University obstetric clinics between January and December 2017. Participants self-reported demographic, Cannabis, and tobacco cigarette use characteristics, and provided urine and hair samples for drug testing. Within two weeks after due date, research staff reviewed participants' electronic medical records to collect birth outcome data. Results showed that 9.0% reported co-use of Cannabis and tobacco, 12.1% reported Cannabis only use, 7.8% reported tobacco cigarette only use, and 71.1% reported no Cannabis or tobacco cigarette use in the past month. The birth outcomes to emerge as significant correlates of co-use of Cannabis and tobacco cigarettes were small head circumference, and the occurrence of birth defects, with the co-use group having the highest odds of a small head circumference [aOR: 5.7 (1.1-28.9)] and birth defects [aOR: 3.1 (1.2-8.3)] compared with other use groups. The Cannabis only group had 12 times higher odds of a stillbirth or miscarriage (aOR = 12.1). Screening and interventions to address concurrent Cannabis and tobacco use during pregnancy are needed, particularly among subpopulations with higher co-use rates. It is imperative to further explore and highlight the possible health implications of maternal co-use given the high prevalence rates found in this study sample.

Cannabis use and stressful life events during the perinatal period: cross‐sectional results from Pregnancy Risk Assessment Monitoring System (PRAMS) data, 2016

“…lower education, lower income) in urban areas and who use other substances during pregnancy (e.g. tobacco, alcohol) [1,2].…”

“…Further, there is some suggestion cannabis use may cause both short-(e.g. miscarriage, stillbirth) [2] and long-term negative health effects (e.g. poor executive functioning, emotional and behavioral problems) [5,6].…”

Four-year health trajectories of children prenatally exposed to cocaine and/or cannabis. A retrospective, cohort study in La Pampa, Argentina

“…For this study, children in the UG were selected for their similarity in birth weight and gestational age with the children in the EG, because these factors are known to affect infant morbidity and mortality and control requirements, and may be affected by prenatal exposure to any of the substances used by the mothers (tobacco, alcohol, cannabis or cocaine). 2,[7][8][9][10][11][12][13]17,20,21 In addition, we tried to select children for the UG with a similar socioeconomic level to those in the EG: born at the same Department of Neonatology, with the same social security status, maternal age, and close place of residence. The existence of a double control group with a similar socioeconomic level to the EG is the main strength of this study.…”

Trayectorias sanitarias durante 4 años de niños expuestos prenatalmente a cocaína y/o cannabis. Estudio de cohorte retrospectivo en La Pampa, Argentina

“…nacer y edad gestacional a los niños del GE, por ser conocidos factores que modifican la morbimortalidad infantil y el requerimiento de controles, y que pueden afectarse por la exposición prenatal a cualquiera de las drogas consumidas por sus madres (tabaco, alcohol, cannabis o cocaína). 2,[7][8][9][10][11][12][13]17,20,21 Además, se buscó que los niños del GNE pertenecieran a un nivel socioeconómico similar al del GE: nacidos en el mismo Servicio de Neonatología, con igual situación ante la seguridad social, con edades maternas y lugar de residencia cercanos. La existencia de un grupo de comparación doble de similar nivel socioeconómico que el GE constituye la principal fortaleza de este estudio.…”