Cannabis Use in Pregnancy and Neonatal Outcomes: A Systematic Review and Meta-Analysis.
Cannabis Use in Pregnancy and Neonatal Outcomes: A Systematic Review and Meta-Analysis.
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大麻在妊娠和新生儿结局中的使用：系统评价和荟萃分析。
DOI：
10.1089/can.2022.0262
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发表时间：
2024
影响因子：
3.8
通讯作者：
Harrod,CurtisS
中科院分区：
文献类型：
--
作者：
Lo,JamieO;Shaw,Beth;Robalino,Shannon;Ayers,ChelseaK;Durbin,Shauna;Rushkin,MeganC;Olyaei,Amy;Kansagara,Devan;Harrod,CurtisS
目的：确定产前单独使用大麻是否会增加胎儿和新生儿发病率和死亡率的可能性。研究设计：我们检索了从开始到 2022 年 2 月 14 日的文献数据库，例如 PubMed、Embase、Scopus、Cochrane 评论、PsycInfo、MEDLINE、ClinicalTrials.gov 和 Google Scholar。 产前使用大麻的妊娠中预先指定的胎儿或新生儿结局。主要结局是早产（PTB；妊娠<37周）、小于胎龄（SGA）、出生体重（克）和围产期死亡率。两名独立评审员筛选了研究。研究由一名评审员提取，并由另一名评审员使用预定义的模板进行确认。研究的偏倚风险评估由两名独立评审员进行，使用纽卡斯尔-渥太华质量评估量表以及建议评估、制定和评价分级来评估选定结果的证据的确定性，并由第三名独立评审员解决分歧。使用调整和未调整的效应估计进行随机效应荟萃分析，根据产前大麻使用状况对各组进行比较。结果：纳入了 53 项研究。除出生体重外，未经调整和调整的荟萃分析具有相似的结果。我们发现极低到低质量的证据表明，怀孕期间使用大麻与较高的 PTB 几率显着相关（调整后的比值比 [aOR]，1.42；95% 置信区间 [CI]，1.19 至 1.69；I2，93%；p=0.0001）、SGA（aOR，1.76；95% CI，1.52 至2.05；I2， 86%；p<0.0001）和围产期死亡率（aOR，1.5；95% CI，1.39 至 1.62；I2，0%；p<0.0001），但出生体重无显着差异（平均差，-40.69 g；95% CI，-124.22 至 42.83；I2， 85%；p=0.29）。由于存在很大的异质性，我们还进行了叙述性综合，发现了与荟萃分析相当的结果。 结论：即使考虑到产前烟草使用，产前大麻使用与较高的 PTB、SGA 和围产期死亡率相关。然而，我们对这些发现的信心是有限的。大多数现有研究的局限性是未能不包括使用大麻的时间或数量。该审查可以帮助指导医疗保健提供者提供咨询、管理和解决有限的现有安全数据。方案注册：PROSPERO CRD42020172343。
Objective:To determine whether prenatal cannabis use alone increases the likelihood of fetal and neonatal morbidity and mortality.Study Design:We searched bibliographic databases, such as PubMed, Embase, Scopus, Cochrane reviews, PsycInfo, MEDLINE, Clinicaltrials.gov, and Google Scholar from inception through February 14, 2022. Cohort or case–control studies with prespecified fetal or neonatal outcomes in pregnancies with prenatal cannabis use. Primary outcomes were preterm birth (PTB; <37 weeks of gestation), small-for-gestational-age (SGA), birthweight (grams), and perinatal mortality. Two independent reviewers screened studies. Studies were extracted by one reviewer and confirmed by a second using a predefined template. Risk of bias assessment of studies, using the Newcastle–Ottawa Quality Assessment Scale, and Grading of Recommendations Assessment, Development, and Evaluation for evaluating the certainty of evidence for select outcomes were performed by two independent reviewers with disagreements resolved by a third. Random effects meta-analyses were conducted, using adjusted and unadjusted effect estimates, to compare groups according to prenatal exposure to cannabis use status.Results:Fifty-three studies were included. Except for birthweight, unadjusted and adjusted meta-analyses had similar results. We found very-low- to low-certainty evidence that cannabis use during pregnancy was significantly associated with greater odds of PTB (adjusted odds ratio [aOR], 1.42; 95% confidence interval [CI], 1.19 to 1.69;I2, 93%;p=0.0001), SGA (aOR, 1.76; 95% CI, 1.52 to 2.05;I2, 86%;p<0.0001), and perinatal mortality (aOR, 1.5; 95% CI, 1.39 to 1.62;I2, 0%;p<0.0001), but not significantly different for birthweight (mean difference, −40.69 g; 95% CI, −124.22 to 42.83;I2, 85%;p=0.29). Because of substantial heterogeneity, we also conducted a narrative synthesis and found comparable results to meta-analyses.Conclusion:Prenatal cannabis use was associated with greater odds of PTB, SGA, and perinatal mortality even after accounting for prenatal tobacco use. However, our confidence in these findings is limited. Limitations of most existing studies was the failure to not include timing or quantity of cannabis use. This review can help guide health care providers with counseling, management, and addressing the limited existing safety data.Protocol Registration:PROSPERO CRD42020172343.
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影响因子：
2.9
作者：
Bailey, Beth A.;Wood, David L.;Shah, Darshan
通讯作者：
Shah, Darshan
影响因子：
9.8
作者：
S. Greenland;K. Staisch;N. Brown;S. Gross
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母亲吸食大麻与出生体重：围绕休闲大麻合法化的观察性研究
影响因子：
2
作者：
H. Straub;J. Mou;K. Drennan;B. Pflugeisen
通讯作者：
B. Pflugeisen
产前酒精、大麻和烟草暴露对新生儿行为的影响
影响因子：
2.1
作者：
G. Richardson;N. Day;P. Taylor
通讯作者：
P. Taylor
DOI：
10.1016/j.jpeds.2013.01.036
发表时间：
2013-08
期刊：
The Journal of pediatrics
影响因子：
--
作者：
Alhusen JL;Lucea MB;Bullock L;Sharps P
通讯作者：
Sharps P