Cannabis legalization and use during pregnancy: A Michigan Study

项目摘要 在美国，孕妇使用大麻的人数在过去几年中翻了一番。 医疗和娱乐大麻使用现在在全国许多州都是法律的，这影响了 大麻使用流行率上升。法律的扩张可能会改变对大麻风险的看法， 潜在的误导性信念，即大麻是一种相对安全的物质。大麻的止吐作用 几十年来一直行之有效。因为大麻是用来缓解癌症中的恶心和呕吐 患者，可能会认为大麻可以治疗晨吐。孕吐与怀孕有关 恶心和呕吐，并且有时可能是严重的（即，妊娠剧吐）;这是常见的 怀孕前三个月的孕妇。人们对早晨和早晨之间的关系知之甚少。 疾病和大麻使用。我建议估计产妇使用大麻的可能性， 怀孕期间经历的孕吐，每三个月一次。 目前的文献表明，缺乏明确的证据证明母亲使用大麻与母亲使用大麻之间的因果关系。 不良的短期生育结果。研究结果，如低出生体重，早产，出生，小， 胎龄、Apgar评分、新生儿重症监护室（NICU）入院很重要，因为有可能发生 这些婴儿发病率造成的长期影响。先前的研究缺乏可重复性，可能是由于 方法学问题，如使用回顾性研究设计。 由于密歇根州成为中西部第一个将成年人娱乐性使用大麻合法化的州， 2018年21岁，必须使用前瞻性方法调查产前使用大麻的影响。 队列研究设计。本论文的目的是估计大麻之间的可疑因果关系 怀孕期间的使用，孕吐，和一组出生结果（例如，出生体重，胎龄， 早产，出生时的Apgar评分和出生后的NICU入院） Michigan Archive for Research on Child Health（MARCH）研究的数据。支持NIDA R36 论文奖将使我成为一名独立研究人员，并将加强我的能力， 作为学术界的早期研究者扩展这项工作。

PROJECT SUMMARY Maternal cannabis use among pregnant women has doubled over the last few years in the United States (US). Medical and recreational cannabis use is now legal in many states across the nation which has influenced an increase in cannabis use prevalence. Legal expansion might alter cannabis risk perceptions, leading to the potential misguided belief that cannabis is a relatively safe substance. The antiemetic effects of cannabis have been well-established for decades. Because cannabis is used to alleviate nausea and vomiting in cancer patients, it might be thought that cannabis can treat morning sickness. Morning sickness is pregnancy-related nausea and vomiting, and can sometimes be severe (i.e., Hyperemesis gravidarum); it is common among pregnant women in their first trimester of pregnancy. Little is known about the relationship between morning sickness and cannabis use. I propose to estimate the odds of maternal cannabis use given the severity of morning sickness experienced during pregnancy, trimester-by-trimester. Current literature indicates a lack of clear evidence establishing causality between maternal cannabis use and adverse short-term birth outcomes. Studying outcomes such as low birth weight, preterm, birth, small-for- gestational age, Apgar score, neonatal intensive care unit (NICU) admission is important given the potential for long-term effects that result from these infant morbidities. Prior studies lack reproducibility, possibly due to methodological issues such as the use of retrospective study designs. As Michigan became the first state in the Midwest to legalize the recreational use of cannabis by adults at least 21 years of age in 2018, it is imperative to investigate the effects of prenatal cannabis use using a prospective cohort study design. This dissertation proposal aims to estimate the suspected causal link between cannabis use during pregnancy, morning sickness, and a set of birth outcomes (e.g., birth weight, gestational age, preterm birth, Apgar score at birth, and NICU admission following birth) across pregnancy trimesters using data for the Michigan Archive for Research on Child Health (MARCH) study. The support of the NIDA R36 dissertation award will launch me into the role of an independent researcher, and will strengthen my ability to extend this work as an early stage investigator in academia.