Maternal Marijuana Use During Pregnancy, Marijuana Legalization, and Adverse Obstetrical and Neonatal Outcomes: A 12-year Cohort Study

母亲在怀孕期间吸食大麻、大麻合法化以及不良产科和新生儿结局：一项为期 12 年的队列研究

• 批准号: 10396031
• 负责人: Lyndsay Ammon Avalos
• 金额: $ 62.55万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10396031
• 关键词: Abruptio Placentae; Accounting; Adolescent; Affect; Antiemetics; Biochemical; California; Cannabinoids; Caring; Cesarean section; Child Welfare; Clinical; Clinical Data; Clinical Trials; Cohort Studies; Collection; Commerce; Communities; Conflict (Psychology); Congenital Abnormality; Data; Drug Exposure; Drug usage; Education; Electronic Health Record; Epidemiology; Fetal Death; Fetal Development; Fetal Growth Retardation; Fetal health; First Pregnancy Trimester; Future; Geography; Gold; Health; High Risk Woman; Income; Infant; Intervention Studies; Legal; Literature; Longitudinal cohort study; Low Birth Weight Infant; Marijuana; Maternal Health; Measures; Medical Marijuana; Methodology; Mothers; Natural experiment; Outcome; Patient Self-Report; Patients; Play; Policies; Policy Maker; Population; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Birth; Prenatal care; Prevalence; Provider; Public Health; Regulation; Research Personnel; Resources; Risk; Role; Sample Size; Sampling; Small for Gestational Age Infant; Socioeconomic Status; Spontaneous abortion; Surveys; Testing; Tetrahydrocannabinol; Time; Tobacco; Tobacco use; Toxicology; Urine; Uterus; Variant; Woman; aged; alcohol and other drug; base; blood pressure elevation; cohort; density; design; drug use in pregnancy; drug use screening; endogenous cannabinoid system; epidemiology study; fetal; fetal marijuana exposure; hospital readmission; illicit drug use; insight; marijuana legalization; marijuana use; marijuana use in pregnancy; marijuana user; maternal hypertension; maternal marijuana use; maternal outcome; maternal risk; neonatal health; neonatal outcome; novel; obstetric outcomes; offspring; perinatal outcomes; pregnancy hypertension; pregnant; prenatal; prenatal exposure; prenatal testing; programs; prospective; public health relevance; racial and ethnic; response; risk minimization; screening; screening program; sociodemographics; stillbirth; substance use; trend; vasoconstriction; young adult

PROJECT SUMMARY/ABSTRACT Prenatal marijuana use is increasingly recognized as an important public health problem that could have a large scale negative impact on maternal, fetal and neonatal health. We propose a retrospective and prospective longitudinal cohort study of over 400,000 pregnancies screened for prenatal marijuana use based on gold standard self-reported and urine toxicology data from 2009 to 2020, leveraging Kaiser Permanente Northern California’s universal prenatal substance use screening program that is part of standard prenatal care. We will assess associations between maternal marijuana use during pregnancy and key maternal, fetal and neonatal outcomes, controlling for potential confounders (e.g., tobacco use, alcohol and other drug exposure, income) and comparing exposure across trimesters. These analyses also take advantage of a unique natural experiment and will examine whether California state marijuana legalization in 2018 and local regulatory practices (e.g., retailer bans, prominent warnings on marijuana use during pregnancy) are associated with variation in marijuana use during pregnancy. With high generalizability and a sample size unmatched by any other study on this topic, results from each aim have direct implications for the care of pregnant women while providing novel insight to drive future epidemiological and clinical trial-based intervention studies. Aims 1 and 2 will provide generalizable and comprehensive data to understand the health impact of prenatal marijuana use on mothers and their babies. Aim 3 will allow us to identify changing trends in prenatal marijuana use following marijuana legalization and will inform clinicians, researchers, and policy makers of the future scope of the problem. Finally, the study cohort will be a valuable resource for future research on the long-term impact of prenatal marijuana use on maternal and children’s well-being.

项目总结/文摘