Impact of Prenatal Cannabis Use Disorder on Perinatal Outcomes.
Impact of Prenatal Cannabis Use Disorder on Perinatal Outcomes.
复制标题
产前大麻使用障碍对围产期结局的影响。
DOI：
10.1097/adm.0000000000001123
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发表时间：
2023
影响因子：
5.5
通讯作者：
Lo,JamieO
中科院分区：
文献类型：
--
作者：
Prewitt,KristinC;Hayer,Sarena;Garg,Bharti;Benson,AshleyE;Hedges,MadelineA;Caughey,AaronB;Lo,JamieO
随着大麻合法化的立法变化和使用的日益普遍，大麻是怀孕期间最常用的联邦非法药物。我们的研究旨在评估与产前大麻使用障碍相关的围产期结局。方法：我们进行了一项回顾性队列研究，使用加利福尼亚相关的出院生命统计数据，包括单胎、胎龄在23 - 42周之间的非异常分娩。采用χ 2检验和多变量logistic回归进行统计学分析。结果共纳入2,380,446例患者，其中9144例（0.38%）被确定为妊娠期间使用大麻。不良分娩结局的风险显著增加，包括妊娠期高血压（调整优势比[AOR]， 1.19； 95%可信区间[CI]， 1.06-1.34； P= 0.004）、先兆子痫（AOR, 1.16; 95% CI, 1.0-1.28； P= 0.006）、早产（AOR, 1.45; 95% CI, 1.35-1.55； P< 0.001）和严重产妇发病率（AOR, 1.22; 95% CI, 1.02-1.47； P= 0.033）。产前大麻使用障碍还与新生儿结局的风险增加相关，包括呼吸窘迫综合征（AOR, 1.16; 95% CI, 1.07-1.27； P< 0.001）、胎龄小（AOR, 1.47; 95% CI, 1.38-1.56； P< 0.001）、新生儿重症监护病房入院（AOR, 1.24; 95% CI, 1.16 - 1.33； P< 0.001）和婴儿死亡（AOR, 1.86; 95% CI, 1.44-2.41； P< 0.001）。死产（AOR, 0.96; 95% CI, 0.69-1.34； P= 0.80）和低血糖（AOR, 1.22; 95% CI, 1.00-1.49； P= 0.045）两组差异无统计学意义。结论我们的研究提示产前大麻使用障碍与孕产妇和新生儿发病率和死亡率增加有关。随着怀孕期间大麻使用障碍变得越来越普遍，我们的研究结果可以帮助指导孕前和产前咨询。
ObjectivesWith legislative changes to cannabis legalization and increasing prevalence of use, cannabis is the most commonly used federally illicit drug in pregnancy. Our study aims to assess the perinatal outcomes associated with prenatal cannabis use disorder.MethodsWe conducted a retrospective cohort study using California linked hospital discharge-vital statistics data and included singleton, nonanomalous births occurring between 23 and 42 weeks of gestational age. χ 2 Test and multivariable logistic regression were used for statistical analyses.ResultsA total of 2,380,446 patients were included, and 9144 (0.38%) were identified as using cannabis during pregnancy. There was a significantly increased risk for adverse birthing person outcomes, including gestational hypertension (adjusted odds ratio [AOR], 1.19; 95% confidence interval [CI], 1.06–1.34; P= 0.004), preeclampsia (AOR, 1.16; 95% CI, 1.0–1.28; P= 0.006), preterm delivery (AOR, 1.45; 95% CI, 1.35–1.55; P< 0.001), and severe maternal morbidity (AOR, 1.22; 95% CI, 1.02–1.47; P= 0.033). Prenatal cannabis use disorder was also associated with an increased risk of neonatal outcomes including respiratory distress syndrome (AOR, 1.16; 95% CI, 1.07–1.27; P< 0.001), small for gestational age (AOR, 1.47; 95% CI, 1.38–1.56; P< 0.001), neonatal intensive care unit admission (AOR, 1.24; 95% CI, 1.16–1.33; P< 0.001), and infant death (AOR, 1.86; 95% CI, 1.44–2.41; P< 0.001). There was no statistically significant difference in stillbirth (AOR, 0.96; 95% CI, 0.69–1.34; P= 0.80) and hypoglycemia (AOR, 1.22; 95% CI, 1.00–1.49; P= 0.045)ConclusionsOur study suggests that prenatal cannabis use disorder is associated with increased maternal and neonatal morbidity and mortality. As cannabis use disorder in pregnancy is becoming more prevalent, our findings can help guide preconception and prenatal counseling.