Socioeconomic Status and Adverse Birth Outcomes: A Population-Based Canadian Sample

Campbell, Emily E; Gilliland, Jason A.; Dworatzek, Paula D.N.; Vrijer, Barbra de; Penava, Debbie; Seabrook, Jamie A.

doi:10.1017/s0021932017000062

Cited by 82 publications

(68 citation statements)

References 29 publications

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“…After duplicates were removed, 6542 publications were screened by title and abstract. Of these, 109 were retrieved for full‐text review and 41 studies were included in our scoping review …”

Section: Resultsmentioning

confidence: 99%

Prevalence and outcomes of prenatal recreational cannabis use in high‐income countries: a scoping review

Singh

Filion

Abenhaim

et al. 2019

BJOG

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Background With expanding recreational cannabis legalisation, pregnant women and their offspring are at risk of potentially harmful consequences. Objectives To assess the prevalence of recreational cannabis use among pregnant women, health outcomes associated with prenatal recreational cannabis use, and the potential impact of recreational cannabis legalisation on this population. Search strategy Five databases and the grey literature were systematically searched (2000–2019). Selection criteria Human studies published in English or French reporting on the prevalence of prenatal recreational cannabis use in high‐income countries. Data collection and analysis Data on study characteristics, prenatal substance use, and health outcomes were extracted and qualitatively synthesised. Main results Forty‐one publications met our inclusion criteria. The overall prevalence of prenatal cannabis use varied substantially (min–max: 0.24–22.6%), with the greatest use in the first trimester. In the three studies with temporal data available, rates of prenatal cannabis use increased across years. Only 7/41 and 5/41 studies provided information on gestational age of exposure and frequency of use, respectively. The concomitant use of alcohol, illicit drugs, and tobacco was higher among cannabis users than nonusers. Prenatal cannabis use was associated with select neonatal, but not maternal, health outcomes. There were insufficient data to compare prenatal cannabis use between the pre‐ and post‐legalisation periods. Conclusion Cannabis use among pregnant women is prevalent and may be associated with adverse neonatal outcomes. Future studies should assess the gestational age and frequency of cannabis exposure, and usage patterns prior to and following legalisation. Tweetable abstract Women who consume cannabis during pregnancy could risk predisposing their newborns to poor birth outcomes.

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Section: Resultsmentioning

confidence: 99%

Prevalence and outcomes of prenatal recreational cannabis use in high‐income countries: a scoping review

Singh

Filion

Abenhaim

et al. 2019

BJOG

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“…Epidemiological studies link perinatal cannabis use with low birth weight outcomes, though little is known about whether Δ9-THC alone underlies the fetal growth restriction observed [6][7][8][9][10] . While this is not the first study to show that 3 mg/kg Δ9-THC causes fetal growth restriction, we do believe that it is the first study in rats to demonstrate that this dose leads to symmetrical IUGR with post-natal catch up without any compromise to maternal outcomes.…”

Section: Discussionmentioning

confidence: 99%

Δ9-tetrahydrocannabinol exposure during rat pregnancy leads to symmetrical fetal growth restriction and labyrinth-specific vascular defects in the placenta

Natale

Gustin

Lee

et al. 2020

Sci Rep

124

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1 in 5 women report cannabis use during pregnancy, with nausea cited as their primary motivation. Studies show that (-)-△9-tetrahydrocannabinol (Δ9-THC), the major psychoactive ingredient in cannabis, causes fetal growth restriction, though the mechanisms are not well understood. Given the critical role of the placenta to transfer oxygen and nutrients from mother, to the fetus, any compromise in the development of fetal-placental circulation significantly affects maternal-fetal exchange and thereby, fetal growth. The goal of this study was to examine, in rats, the impact of maternal Δ9-THC exposure on fetal development, neonatal outcomes, and placental development. Dams received a daily intraperitoneal injection (i.p.) of vehicle control or Δ9-THC (3 mg/kg) from embryonic (E)6.5 through 22. Dams were allowed to deliver normally to measure pregnancy and neonatal outcomes, with a subset sacrificed at E19.5 for placenta assessment via immunohistochemistry and qPCR. Gestational Δ9-THC exposure resulted in pups born with symmetrical fetal growth restriction, with catch up growth by postnatal day (PND)21. During pregnancy there were no changes to maternal food intake, maternal weight gain, litter size, or gestational length. E19.5 placentas from Δ9-THC-exposed pregnancies exhibited a phenotype characterized by increased labyrinth area, reduced Epcam expression (marker of labyrinth trophoblast progenitors), altered maternal blood space, decreased fetal capillary area and an increased recruitment of pericytes with greater collagen deposition, when compared to vehicle controls. Further, at E19.5 labyrinth trophoblast had reduced glucose transporter 1 (GLUT1) and glucocorticoid receptor (GR) expression in response to Δ9-THC exposure. In conclusion, maternal exposure to Δ9-THC effectively compromised fetal growth, which may be a result of the adversely affected labyrinth zone development. These findings implicate GLUT1 as a Δ9-THC target and provide a potential mechanism for the fetal growth restriction observed in women who use cannabis during pregnancy. Over the last decade, cannabis use has progressively increased in pregnant women, in part due to the perception that its usage poses no risk in perinatal life 1,2. In the United States, the rates of self-reported or screened cannabis use in pregnant mothers (18-24 years) varies from 6 to 22%, with some women admitting to daily use 2,3. Of great concern is that cannabis use in pregnancy is more prevalent in young, urban, socially disadvantaged women 4,5 .

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“…Socioeconomic status (SES) is a powerful determinant of human health and disease, and social inequality is a ubiquitous stressor for human populations globally (Bogin, ; Goodman & Leatherman, ; Stinson, Bogin, & O'Rourke, ). For example, lower levels of education and/or income predict increased risk for all‐cause mortality (Meara, Richards, & Cutler, ; Nandi, Glymour, & Subramanian, ), heart disease (Diez‐Roux et al, ; Gonzalez, Artalejo, & Calero, ), diabetes (Brancati, Whelton, Kuller, & Klag, ; Everson, Maty, Lynch, & Kaplan, ), many cancers (Ward et al, ), depression (Lorant et al, ), adverse birth outcomes (Blumenshine, Egerter, Barclay, Cubbin, & Braveman, ; Campbell et al, ), and infectious disease (Cohen, Doyle, Turner, Alper, & Skoner, ). Furthermore, lower SES is associated with physiological processes that contribute to the development of disease, including but not limited to chronic inflammation, reduced cell‐mediated immunity, insulin resistance, cortisol dysregulation, and enhanced sympathetic nervous system activation (Chen & Miller, ; Cohen, Doyle, & Baum, ; McDade, Lindau, & Wroblewski, ; McEwen & Gianaros, ).…”

Section: Introductionmentioning

confidence: 99%

Genome‐wide analysis of DNA methylation in relation to socioeconomic status during development and early adulthood

McDade

Ryan

Jones

et al. 2019

American J Phys Anthropol

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Objectives: Socioeconomic status (SES) is a powerful determinant of health, but the underlying biological mechanisms are poorly understood. This study investigates whether levels of DNA methylation at CpG sites across the genome are associated with SES in a cohort of young adults in the Philippines.Methods: DNA methylation was assayed with the Illumina HumanMethylation450 Bead Chip, in leukocytes from 489 participants in the Cebu Longitudinal Health and Nutrition Survey (mean age = 20.9 years). SES was measured in infancy/childhood and adulthood, and was based on composite measures of income, assets, and education. Genome-wide analysis of variable probes identified CpG sites significantly associated with SES after adjustment for multiple comparisons. Functional enrichment analysis was used to identify biological pathways associated with these sites.Results: A total of 2,546 CpG sites, across 1,537 annotated genes, were differentially methylated in association with SES. In comparison with high SES, low SES was associated with increased methylation at 1,777 sites, and decreased methylation at 769 sites. Functional enrichment analysis identified over-representation of biological pathways related to immune function, skeletal development, and development of the nervous system.Conclusions: Socioeconomic status predicts DNA methylation at a large number of CpG sites across the genome. The scope of these associations is commensurate with the wide range of biological systems and health outcomes that are shaped by SES, and these findings suggest that DNA methylation may play an important role. K E Y W O R D S epigenetics, health disparities, human growth and development

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Socioeconomic Status and Adverse Birth Outcomes: A Population-Based Canadian Sample

Cited by 82 publications

References 29 publications

Prevalence and outcomes of prenatal recreational cannabis use in high‐income countries: a scoping review

Prevalence and outcomes of prenatal recreational cannabis use in high‐income countries: a scoping review

Δ9-tetrahydrocannabinol exposure during rat pregnancy leads to symmetrical fetal growth restriction and labyrinth-specific vascular defects in the placenta

Genome‐wide analysis of DNA methylation in relation to socioeconomic status during development and early adulthood

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