731: Maternal marijuana use and adverse perinatal outcomes among live birth controls

Abstract

The Stillbirth Collaborative Research Network (SCRN) demonstrated an association between marijuana use and stillbirth. Our aim was to examine if maternal marijuana use is associated with adverse perinatal outcomes among live birth controls. Secondary analysis of singleton, live birth controls in the SCRN dataset. Marijuana use was measured by self-report and/or the presence of delta-9-tetrahydrocannabinol (THC) in umbilical cord homogenate. Tobacco use was measured by self-report and/or presence of cotinine in serum. The primary outcome was a composite of small for gestational age (SGA), spontaneous preterm birth (SPTB), and hypertensive disorders of pregnancy (HTN). Effect of maternal marijuana use on the probability of an adverse outcome was estimated using weighted methodology to account for over-sampling in the original study. Analysis of THC in cord homogenate was among a subset of women for whom biospecimens were available. Maternal marijuana use was identified in 58/1725 (3.4%) births. Use was self-reported by 42/1725 and detected by THC in cord homogenate for 19/947. Rate of tobacco use was 11% (188/1722 by self-report and 156/1409 by serum cotinine). The composite adverse perinatal outcome, and each component of the composite outcome, was present more frequently in women with marijuana use compared to non-users, Table. The interaction between marijuana and tobacco was not significant (all p>0.4), and was not included in multivariable models. After adjustment for race, history of preterm delivery, and body mass index, the association of marijuana use with adverse perinatal outcomes was not significant (aOR 1.32, 95% CI 0.59-2.96), but that of tobacco use was (aOR 1.66, 95% CI 1.11-2.47), Figure. Similarly, among women with umbilical cord homogenate and serum cotinine data (n=811), the association of marijuana use with adverse perinatal outcomes remained non-significant (aOR 1.03, 95% CI 0.20-5.47), with the effect of tobacco use greater in magnitude (aOR 2.46, 95% CI 1.31-4.63), Figure. While the effect of maternal marijuana use was not associated with adverse perinatal outcomes independent of tobacco use, the potential for harm due to marijuana use during pregnancy warrants further investigation as we observed increased frequencies of the composite outcome and each component of the composite (SGA, SPTB, HTN) among marijuana users.View Large Image Figure ViewerDownload Hi-res image Download (PPT)