Screening and Management of Substance Use in Pregnancy: A Review

Cook, Jocelynn L.; Green, Courtney R.; Ronde, Sandra de la; Dell, Colleen Anne; Graves, Lisa; Morgan, Lisa; Ordean, Alice; Ruiter, James; Steeves, Megan; Wong, Suzanne

doi:10.1016/j.jogc.2017.07.017

Cited by 24 publications

(15 citation statements)

References 41 publications

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“…Identification of women who use cannabis in pregnancy may facilitate interventions to improve obstetrical and neonatal outcomes (Fried and Makin 1987). The potential for underreporting of cannabis exposure in pregnancy is a challenge for understanding prevalence and identifying opportunities for intervention (Cook et al 2017). BORN data on the use of cannabis in pregnancy are from self-reports, which are likely to be influenced by stigma, social desirability bias, and fear of intervention by child protection services (Greaves and Poole 2004; Stone 2015; Yonkers et al 2011; Jacobson et al 1991; Johnson and Fendrich 2005).…”

Section: Discussionmentioning

confidence: 99%

Trends and correlates of cannabis use in pregnancy: a population-based study in Ontario, Canada from 2012 to 2017

Corsi

Hsu

Weiß

et al. 2018

Can J Public Health

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ObjectiveForthcoming legislative changes will legalize and make cannabis widely available in Canada. We conducted an analysis of Ontario’s birth registry to determine recent trends and correlates of cannabis use in pregnancy.MethodsWe conducted a population-based retrospective cohort study assembled from the Better Outcomes Registry & Network (BORN) Ontario database, covering live births and stillbirths in Ontario between April 2012 and December 2017. Trends in self-reported cannabis use in pregnancy were analyzed according to maternal age and area-level socio-economic status (SES) using log binomial regression analysis.ResultsA total of 10,731 women reported cannabis use in pregnancy. Prevalence increased from 1.2% in 2012 to 1.8% in 2017 (p-trend, < 0.001), equivalent to a relative increase of 61% (relative risk [RR] 1.61, 95% confidence interval [CI] 1.51 to 1.72). The crude prevalence of cannabis use in pregnancy among women aged 15 to 24 years and in the lowest two area-level income quintiles was 6.7%, compared to 0.3% among women aged 35 years and over in the highest three income quintiles (RR 24.59, 95% CI 21.98 to 27.52). A majority (52.0%) of cannabis users were aged 15–24 years and 54.7% of users were in the lowest two income quintiles.ConclusionCannabis use in pregnancy has increased since 2012 in Ontario and was reported in about 2% of pregnancies in 2017. Increases were predominately among women of younger ages and those of lower SES, and these groups account for half of users. Promoting cannabis cessation in pregnancy could lead to improved perinatal and later childhood outcomes and reduce health inequalities.Electronic supplementary materialThe online version of this article (10.17269/s41997-018-0148-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Trends and correlates of cannabis use in pregnancy: a population-based study in Ontario, Canada from 2012 to 2017

Corsi

Hsu

Weiß

et al. 2018

Can J Public Health

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“…We used data from obstetric charts to identify women who used cannabis during pregnancy. Obstetric charts include cannabis use disorders that were self-reported or detected through toxicology screening [19]. We identified women with a previous history of cannabis use disorder using data from past hospitalizations prior to study entry.…”

Section: Cannabis Use Disordersmentioning

confidence: 99%

Cannabis use disorder and the future risk of cardiovascular disease in parous women: a longitudinal cohort study

Auger

Paradis

Low

et al. 2020

BMC Med

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Background Cannabis use is increasing in women of reproductive age, but whether cannabis use disorders increase the long-term risk of cardiovascular disease in this population is not known. Cannabis may cause tachycardia, hypertension, cerebral vasoconstriction, and other adverse cardiovascular effects and has been associated with acute myocardial infarction and stroke. Data on the long-term effects of cannabis on the cardiovascular system are more limited. We assessed the relationship between cannabis use disorders early in life and the future risk of cardiovascular disease in women. Methods We analyzed a longitudinal cohort of 1,247,035 pregnant women in Quebec, Canada, between 1989 and 2019. The main exposure was current or past history of cannabis use disorders at cohort entry. The main outcome measure included future hospital admission for any cardiovascular disorder during 18,998,986 person years of follow-up. We used Cox proportional hazards regression models adjusted for patient characteristics to compute hazard ratios (HR) and 95% confidence intervals (CI) for the association of cannabis use disorder with the later risk of cardiovascular hospitalization. Results Women with cannabis use disorders had a higher incidence of cardiovascular hospitalization than unexposed women (58.4 vs. 33.6 per 10,000 person years). Cannabis use disorder was associated with 1.48 times the risk of cardiovascular hospitalization (95% CI 1.27–1.72), compared with no cannabis use disorder. The association was greater for cannabis with concomitant use of other substances (HR 1.84, 95% CI 1.53–2.21) than for cannabis alone (HR 1.30, 95% CI 0.99–1.72). Cannabis use disorder was strongly associated with hemorrhagic stroke, even with adjustment for other substance use (HR 2.08, CI 1.07–4.05). Conclusions Cannabis use disorders may increase the long-term risk of cardiovascular disease in women, particularly hemorrhagic stroke. However, some of the excess risk may be due to concomitant use of other substances.

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“…Another interesting finding in our study is the elucidation of the changes in BDEs miRNAs in the PNO offspring. Emerging evidence shows that new mothers tend to have a high prevalence of illicit drug use associated with postpartum depression and postoperative pain [68]. Interestingly, we identified some new signatures of BDEs miRs-9277, 7977, and 451-5p to be upregulated while miRs-544-3p, 26a-2, let7c-2, 190a-5p, and 1306-5p were downregulated in the PNO offspring.…”

Section: Discussionmentioning

confidence: 76%

Brain-Derived Extracellular Vesicle microRNA Signatures Associated with In Utero and Postnatal Oxycodone Exposure

Shahjin

Guda

Schaal

et al. 2019

Cells

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Oxycodone (oxy) is a semi-synthetic opioid commonly used as a pain medication that is also a widely abused prescription drug. While very limited studies have examined the effect of in utero oxy (IUO) exposure on neurodevelopment, a significant gap in knowledge is the effect of IUO compared with postnatal oxy (PNO) exposure on synaptogenesis-a key process in the formation of synapses during brain development-in the exposed offspring. One relatively unexplored form of cell-cell communication associated with brain development in response to IUO and PNO exposure are extracellular vesicles (EVs). EVs are membrane-bound vesicles that serve as carriers of cargo, such as microRNAs (miRNAs). Using RNA-Seq analysis, we identified distinct brain-derived extracellular vesicle (BDEs) miRNA signatures associated with IUO and PNO exposure, including their gene targets, regulating key functional pathways associated with brain development to be more impacted in the IUO offspring. Further treatment of primary 14-day in vitro (DIV) neurons with IUO BDEs caused a significant reduction in spine density compared to treatment with BDEs from PNO and saline groups. In summary, our studies identified for the first time, key BDE miRNA signatures in IUO-and PNO-exposed offspring, which could impact their brain development as well as synaptic function.Cells 2020, 9, 21 2 of 18 lack of studies that have compared the effect of in utero oxy (IUO) and postnatal oxy (PNO) exposure on synaptogenesis-a key process of the formation of synapses during brain development-in the exposed offspring. Synapses are key communication points between neurons, which play a critical role in the regulation of neurotransmission and brain plasticity [6].One relatively unexplored form of cell-cell communication associated with brain development in response to IUO and PNO exposure is extracellular vesicles (EVs) [7][8][9]. These membrane-bound vesicles, comprised of exosomes and microvesicles, originate from the multivesicular bodies and plasma membrane, respectively. Furthermore, these EVs, which carry a repertoire of cargo, including microRNAs (miRNAs), are shown to induce inflammation and subsequent neuronal damage, thus serving as key mediators of pathogenesis in several neurological and neurodegenerative disorders [10,11]. The main objective of this study was to identify differentially expressed BDEs miRNAs using RNA sequencing (RNA-Seq) and evaluate their impact on synaptic architecture during a key stage of brain development.

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Screening and Management of Substance Use in Pregnancy: A Review

Cited by 24 publications

References 41 publications

Trends and correlates of cannabis use in pregnancy: a population-based study in Ontario, Canada from 2012 to 2017

Trends and correlates of cannabis use in pregnancy: a population-based study in Ontario, Canada from 2012 to 2017

Cannabis use disorder and the future risk of cardiovascular disease in parous women: a longitudinal cohort study

Brain-Derived Extracellular Vesicle microRNA Signatures Associated with In Utero and Postnatal Oxycodone Exposure

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