Trajectories of Cannabis Use in Pregnancy

怀孕期间使用大麻的轨迹

• 批准号: 10518922
• 负责人: Katrina Mark
• 金额: $ 55.44万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10518922
• 关键词: Abstinence; Admission activity; Adverse effects; Affect; Area; Back; Birth; Birth Weight; California; Cannabinoids; Cannabis; Categories; Characteristics; Collaborations; Collection; Control Groups; Counseling; Cross-Sectional Studies; Data; Demographic Factors; Development; Dose; Enrollment; Evaluation; First Pregnancy Trimester; Frequencies; Future; Gestational Age; Goals; Head circumference; Health; Health Personnel; Health Professional; Health Status; High Risk Woman; Institution; Intervention; Knowledge; Lead; Maryland; Maternal Health; Maternal and Child Health; Measures; Medical; Mental Health; Modeling; Motivation; Neonatal Intensive Care Units; Newborn Infant; Outcome; Participant; Patient Self-Report; Pattern; Perception; Persons; Placenta; Positioning Attribute; Postpartum Period; Pregnancy; Pregnancy Outcome; Pregnant Women; Prenatal care; Professional Organizations; Provider; Readiness; Recommendation; Recording of previous events; Reporting; Research; Research Personnel; Risk; Site; Surveys; Symptoms; Tetrahydrocannabinol; Time; TimeLine; Urine; Variant; Woman; adverse outcome; adverse pregnancy outcome; care delivery; clinical research site; cohort; comparison group; drug testing; experience; fetal marijuana exposure; high risk; improved; innovation; marijuana use; marijuana use disorder; marijuana use in pregnancy; maternal outcome; neonatal outcome; neonate; neurodevelopment; pregnant; prenatal exposure; prospective; recruit; risk perception; screening; social; social health determinants; substance use; success; virtual

Cannabis use in pregnancy is becoming increasingly common despite recommendations from healthcare providers and professional organizations for abstinence. Evidence exists that cannabis exposure in utero, particularly after the first trimester, is associated with risks of adverse pregnancy outcomes and negative effects on the long-term neurodevelopment of the exposed neonate. Despite this, approximately one in four pregnant women who uses cannabis will continue to use throughout her pregnancy. The data that exist currently suggest that continued use in pregnancy is associated with the highest risk of adverse outcomes. However, most of our understanding of patterns of use come from cross-sectional surveys and consist only of the binary outcomes of continuation or abstinence. There is a need for longitudinal data evaluating trajectories of cannabis use during pregnancy, including changes such as decreases in use. Defining these trajectories will help to further delineate if a dose-dependent relationship between exposure and outcomes exist. Equally as important, understanding both baseline and time-varying factors that are associated with different cannabis use trajectories can be used to inform counseling, support and treatment efforts with the ultimate goal of improving maternal and child health. We plan to recruit 1,200 pregnant people who present for prenatal care at six different clinical sites across two institutions in Maryland and California. The cohort will include 800 people who self-report cannabis use within the 30 days prior to pregnancy recognition and 400 who do not. We will collect baseline demographic information, health and mental health history and detailed information on frequency, quantity and mode of cannabis use and other substances prior to and since recognition of pregnancy. We will then follow these women throughout pregnancy with monthly, electronic surveys using Timeline Followback to quantify use. In addition to self-report of use, we will use urine drug testing for confirmation. Latent Variable Mixture Modeling will be used to define varying trajectories of cannabis use in pregnancy. In order to evaluate both baseline and time-varying factors associated with differing trajectories of use, we will also capture data on mental health status, pregnancy symptoms, motivations and intentions for use and social determinants of health at enrollment and once per trimester throughout pregnancy. We will compare birth outcomes between different cannabis use trajectories and those of women who do not use. We intend to 1) define trajectories of cannabis use during pregnancy among women who used cannabis within the month prior to pregnancy recognition 2) determine both baseline and time-varying factors associated with different cannabis use trajectories 3) compare birth outcomes across cannabis use trajectories to those of pregnant people who do not use cannabis. The results of this study will aid in the development of more comprehensive approaches to cannabis use counseling and treatment with the goal of improving maternal health and decreasing rates of substance exposed newborns. Additionally, our results will inform future studies on the effects of in utero cannabis use exposure.

尽管医疗保健提供者和 禁欲的专业组织。有证据表明大麻在子宫内暴露，特别是在第一次 孕期与不良妊娠结局的风险有关，对长期的负面影响 裸露的新生儿的神经发育。尽管如此，大约四分之一的孕妇使用大麻 她将在整个怀孕期间继续使用。 目前存在的数据表明，持续使用怀孕与不利的最高风险有关 结果。但是，我们对使用模式的大多数理解都来自横截面调查，仅由 延续或禁欲的二元结果。需要评估的纵向数据 怀孕期间的大麻使用，包括使用量减少的变化。定义这些轨迹将有助于 如果存在暴露与结果之间的剂量依赖关系，则进一步描述。同样重要， 了解与不同大麻使用轨迹相关的基线和时变因素可以是 用于为咨询，支持和治疗工作提供信息，以实现改善产妇和儿童健康的最终目标。 我们计划招募1,200名孕妇，他们在两个不同的六个不同的临床部位参加产前护理 马里兰州和加利福尼亚的机构。该队列将包括800人在30中自我报告大麻使用 怀孕识别前几天，没有400人。我们将收集基线人口统计信息，健康和 心理健康历史以及有关大麻使用频率，数量和模式以及其他物质的详细信息 在识别怀孕之前和之后。然后，我们将在整个怀孕期间每月关注这些妇女， 电子调查使用时间轴后背进行量化使用。除了使用自我报告，我们还将使用尿液药物 测试确认。潜在可变混合物建模将用于定义大麻使用的不同轨迹 怀孕。为了评估与使用轨迹不同的基线和时变因素，我们 还将捕获有关心理健康状况，怀孕症状，动机和使用和社交意图的数据 整个怀孕期间，入学率的健康决定因素，每三个月一次。我们将比较出生结果 在不同的大麻使用轨迹和不使用女性的轨迹之间。 我们打算1）在怀孕期间使用大麻在 怀孕识别前一个月2）确定与不同的基线和时变因子 大麻使用轨迹3）将大麻跨轨迹的出生结果与怀孕者的出生结果进行比较 不要使用大麻。 这项研究的结果将有助于开发更全面的大麻使用咨询和 治疗的目的是改善孕产妇的健康和降低物质裸露的新生儿的率。 此外，我们的结果将为未来关于子宫内使用的影响的研究提供信息。