Teen Mothers’ Prenatal Cannabis Use and Co-Use with Tobacco

关于怀孕青少年使用大麻的安全性的科学迫切需要赶上快速发展的步伐。 随着大麻的共同使用增加，沿着当今大麻的接受度、可用性和效力增加 烟草。怀孕的青少年可能比怀孕的成年人更难戒烟， 大麻大麻的效力是早期成年母亲队列研究中使用的大麻的三倍。 然而，对成年母亲的早期研究发现产前大麻暴露（PCE）的微妙而持久的影响 和产前烟草暴露（PTE）对行为结果的影响。这项研究是基于大量的证据 显示青少年和成年母亲使用药物之间的显着差异，最近的社会变化， 大麻的使用，以及与烟草共同使用的危险。关键是要确定大麻和共同使用 怀孕的青少年与其他怀孕的青少年不同，为了确定PCE和共同暴露对他们的影响， 产后的婴儿和家庭功能。目标1：确定母亲和家庭特征 与怀孕青少年从第一个三个月到第六个三个三个月的大麻使用和与烟草共同使用相关 产后12个月目标2：确定暴露于PCE以及与 烟草对婴儿神经发育和记忆，以及母亲的心理健康，感知压力和使用 社会服务，控制怀孕青少年之间的基线差异。该研究采用了 采用混合方法调查青少年母亲在怀孕期间和怀孕后使用大麻和烟草的情况， 与大麻和烟草使用的持久性和停止有关的因素，以及PCE的影响 以及在分娩、6个月和12个月时对母婴结局的共同使用。我们将筛选1,120名怀孕少女 招募620名女孩进行一项前瞻性纵向研究。我们将匹配这4个 种族、年龄和保险状况组：纯大麻（PCE）、纯烟草（PTE）、大麻+烟草 (PCE+PTE）和非用户。参与者将在第二和第三个三个月以及产后6个月进行观察。 分娩和新生儿数据将从所有活产婴儿的医疗记录中提取， 公共服务使用情况将从电子健康记录和PA人类部门获得 服务数据仓库产后12个月。将测量母体物质使用和功能 使用时间轴随访访谈、片剂标准化评估和生物定量。婴儿 产后6个月评估发育、气质和二手烟暴露。用于 更好地了解怀孕和养育子女的青少年的信仰，态度和他们的大麻的社会背景 并与烟草共同使用，子样本（n=15/组）将在每个时间点完成定性访谈。的 标准化评估、丰富的定性数据、生物量化、电子 医疗记录和公共服务数据将提供目前围产期大麻使用的可靠和公正的数据 以及与烟草同时使用的孕妇青少年、相关的母亲特征和婴儿结局。

The science regarding the safety of cannabis use in pregnant teens urgently needs to catch up to the rapidly increasing acceptance, availability, and potency of today’s cannabis, along with increasing co-use of cannabis with tobacco. Pregnant teens may find it more difficult than pregnant adults to quit smoking tobacco and cannabis. Cannabis is three times more potent than the cannabis used in earlier cohort studies of adult mothers. Yet, older studies with adult mothers found subtle yet persistent effects of prenatal cannabis exposure (PCE) and prenatal tobacco exposure (PTE) on behavioral outcomes. This study is based upon the body of evidence showing striking differences between substance use in teen and adult mothers, recent societal changes in cannabis use, and the dangers of co-use with tobacco. It is crucial to determine whether cannabis and co-using pregnant teens differ from other pregnant teens, and to determine the effects of PCE and co-exposure on their infants and family functioning in the postpartum. Aim 1: Determine maternal and family characteristics associated with cannabis use and co-use with tobacco in pregnant adolescents from the 1st trimester through 6 and 12 months postpartum. Aim 2: Identify trimester-specific effects of exposures to PCE and co-use with tobacco on infant neurodevelopment and memory, as well as maternal mental health, perceived stress, and use of social services, controlling for baseline differences among pregnant adolescents. The proposed study uses a mixed-methods approach to investigate cannabis and tobacco use in teen mothers during and after pregnancy, factors associated with their persistence and desistance of cannabis and tobacco use, and the effects of PCE and co-use on mother and infant outcomes at delivery, 6, and 12 months. We will screen 1,120 pregnant teens for 1st trimester substance use, to recruit 620 girls for a prospective, longitudinal study. We will match these 4 groups on race, age, and insurance status: cannabis-only (PCE), tobacco-only (PTE), cannabis + tobacco (PCE+PTE), and non-users. Participants will be seen at the 2nd and 3rd trimesters, and 6 months postpartum. Delivery and neonatal data will be extracted from medical records for all live births, and data on medical and public services usage will be obtained from the electronic health record and the PA Department of Human Services Data Warehouse 12 months postpartum. Maternal substance use and functioning will be measured using Timeline Followback interviews, standardized assessments on tablets, and biological quantification. Infant development, temperament, and secondhand smoke exposure will be assessed 6 months postpartum. For a better understanding of pregnant and parenting teens’ beliefs, attitudes, and the social contexts of their cannabis and co-use with tobacco, a subsample (n=15/group) will complete qualitative interviews at each time point. The innovative combination of standardized assessments, rich qualitative data, biological quantification, electronic medical record, and public services data will provide robust and unbiased data of current perinatal cannabis use and co-use with tobacco in pregnant teens, associated maternal characteristics, and infant outcomes.