Risk of neonatal and childhood morbidity among preterm infants exposed to marijuana.
Risk of neonatal and childhood morbidity among preterm infants exposed to marijuana.
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DOI：
10.1080/14767058.2016.1269165
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发表时间：
2017-12
期刊：
影响因子：
--
通讯作者：
Metz TD
中科院分区：
文献类型：
--
作者：
Dotters-Katz SK;Smid MC;Manuck TA;Metz TD
关于宫内暴露于大麻（MJ）的婴儿，特别是早产儿的新生儿和神经发育结果的数据有限。我们假设，与未接触MJ的婴儿相比，接触MJ的早产儿的新生儿和儿童发育结果会更差。对产前硫酸镁预防脑瘫的多中心随机对照试验进行次要分析。将宫内暴露于MJ <35周的单胎非异常婴儿与未暴露于MJ的婴儿进行比较。主要新生儿结局为出院前死亡、3/4级脑室内出血、脑室周围白质软化、支气管肺发育不良和/或II/III期坏死性小肠结肠炎。主要的儿童结局是死亡、中度/重度脑瘫或/和2岁时Bayley II量表<70。后向逐步回归用于估计主要结局的几率。1，867名婴儿符合入选标准; 135名（7.2%）暴露于MJ。接触MJ的婴儿与未接触MJ的婴儿相比，新生儿（20%vs26%，p=0.14）或儿童期（26%vs21%，p=0.21）的结局无差异。在校正模型中，MJ暴露与不良新生儿结局（aOR 0.83，95%CI 0.47，1.44）或儿童早期结局（aOR 1.47，95%CI 0.97，2.23）无关。在小于35孕周出生的婴儿中，MJ暴露与不良新生儿或儿童结局无关。需要长期随访研究来评估MJ暴露后儿童期神经发育的结果。
Limited data exist regarding the neonatal and neurodevelopmental outcomes of infants exposed to marijuana (MJ) in-utero, particularly among preterm infants. We hypothesized that MJ-exposed preterm infants would have worse neonatal and childhood developmental outcomes compared to MJ-unexposed infants. Secondary analysis of multicenter randomized-controlled trial of antenatal magnesium sulfate for prevention of cerebral palsy was conducted. Singleton non-anomalous infants delivered <35 weeks exposed to MJ in-utero were compared to MJ-unexposed. Primary neonatal outcome was death, grade 3/4 intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, and/or stage II/III necrotizing enterocolitis before discharge. Primary childhood outcome was death, moderate/severe cerebral palsy, or/and Bayley II Scales <70 at age 2. Backwards-stepwise regression used to estimate odds of primary outcomes. 1,867 infants met inclusion criteria; 135(7.2%) were MJ-exposed. There were no differences in neonatal (20%vs26%, p=0.14) or childhood (26%vs21%, p=0.21) outcomes in MJ-exposed infants compared to MJ-unexposed infants. In adjusted models, MJ-exposure was not associated with adverse neonatal outcomes (aOR 0.83 95%CI 0.47,1.44) or early childhood outcomes (aOR 1.47, 95%CI 0.97, 2.23). Among infants born <35 weeks of gestation, MJ-exposure was not associated with adverse neonatal or childhood outcomes. Long-term follow up studies are needed to assess later childhood neurodevelopmental outcomes following MJ-exposure.
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