Marijuana use and its effects in pregnancy
Marijuana use and its effects in pregnancy
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DOI：
10.1016/j.ajog.2016.05.044
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发表时间：
2016-10-01
影响因子：
9.8
通讯作者：
Aagaard, Kjersti M.
中科院分区：
文献类型：
--
作者：
Chabarria, Kristin C.;Racusin, Diana A.;Aagaard, Kjersti M.
背景：一般认为大麻是怀孕期间使用最广泛的受控物质之一。然而，关于其使用和随后的围产期发病率的人口数据仍然普遍缺乏。我们假设，在怀孕期间直接询问患者有关大麻、烟草和尼古丁的使用情况，将提供关于围产期风险的关键的基于人群的初始数据。目的：我们的研究旨在检查报告有大麻暴露的孕妇的母亲和新生儿结局，单独或与母亲吸烟相结合。我们对具有大麻使用和妊娠结局相关信息的受试者（n = 12，069）进行了回顾性队列研究设计。自2011年以来，我们经常直接询问所有孕妇使用大麻，烟草和含尼古丁产品的情况。我们研究了大麻吸烟者与不吸烟者的围产期结局，以及同时报告大麻和香烟吸烟的患者。多变量分析能够确定调整后的比值比的母亲和胎儿的结果，调整混杂因素。显著性用Mann-Whitney U，chi（2）和Fischer精确检验（如适用）确定。结果：106/12，069人报告使用大麻（0.88%），48/12，069人（0.4%;或48/106，45%）同时使用香烟和大麻。在控制了潜在的混杂变量后，虽然单独使用大麻与显著的不良结局无关，但与吸烟联合使用与多种不良围产期结局的风险增加显著相关（母亲哮喘发生率增加[校正比值比，2.4; 95%置信区间，1.0-5.9];早产[校正比值比，2.6; 95%置信区间，1.3e4.9];下降[
BACKGROUND: It is generally assumed that marijuana is one of the more widely used controlled substances during pregnancy. However, there remains a general paucity of population-based data regarding its use and subsequent perinatal morbidity. We hypothesized that direct patient query during pregnancy regarding marijuana, tobacco, and nicotine use would provide crucial initial population-based data on perinatal risk.OBJECTIVE: Our study sought to examine maternal and neonatal outcomes in pregnancies with reported marijuana exposure, in isolation or in combination with maternal cigarette smoking.STUDY DESIGN: We applied a retrospective cohort study design to subjects (n = 12,069) with available information on marijuana use and pregnancy outcomes. Since 2011, we have routinely and directly questioned all gravidae regarding use of marijuana, tobacco, and nicotine-containing products. We examined perinatal outcomes in marijuana smokers vs nonsmokers, as well as patients reporting both marijuana and cigarette smoking. Multivariate analysis enabled determination of adjusted odds ratios for maternal and fetal outcomes, adjusting for confounders. Significance was determined with Mann-Whitney U, chi(2), and Fischer exact tests (as appropriate).RESULTS: In all, 106/12,069 reported marijuana use (0.88%), with 48/12,069 (0.4%; or 48/106, 45%) concurrently using cigarettes and marijuana. After controlling for potential confounding variables, while marijuana use alone was not associated with significant adverse outcomes, use in combination with cigarette smoking was significantly associated with increased risk of multiple adverse perinatal outcomes (increased occurrence of maternal asthma [adjusted odds ratio, 2.4; 95% confidence interval, 1.0-5.9]; preterm birth [adjusted odds ratio, 2.6; 95% confidence interval, 1.3e4.9]; decreased [