Abstract

BackgroundAs cannabis consumption is increasing globally, including among pregnant women, there is a critical need to understand the effects of cannabis on fetal development and birth outcomes. We had two objectives: to determine 1) the factors associated with self-reported cannabis use in the pre/early-pregnancy period, and 2) whether cannabis use is associated with low birth weight, preterm birth, or small size for gestational age (GA) infants.MethodsMaternal questionnaire and birth outcome data was gathered from 2229 women and 1778 singleton infants in the Ontario Birth Study, a hospital-based prospective cohort study (2013–2019). Women self-reported cannabis use within 3 months of learning their pregnancy status. Multivariable linear and logistic regression was conducted to 1) identify factors associated with cannabis use, and 2) determine the associations between cannabis use with the selected birth outcomes.ResultsCannabis use increased in the cohort over time. Women who reported cannabis use (N = 216) were more likely to be younger and more likely to use alcohol, tobacco, and prescription pain medication, although most did not. These women had infants born at lower average birth weights and had 2.0 times the odds of being small for GA (95% confidence interval: 1.3, 3.3) after multivariable adjustment for socioeconomic factors and other substance use.ConclusionOur results suggest that women who use cannabis around the time of conception have higher odds of having infants that are small for gestational age. Targeted clinical messaging may be most applicable to women actively trying to conceive.

Highlights

  • As cannabis consumption is increasing globally, including among pregnant women, there is a critical need to understand the effects of cannabis on fetal development and birth outcomes

  • Study population Among the 2229 women included for analysis of factors associated with pre/early-pregnancy cannabis use, the mean age was 33.7(3.8) years at baseline, and pre-pregnancy body mass index (BMI) was 23.4(4.6)

  • Jewish ethnicity was the third most commonly reported at 14.9%

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Summary

Introduction

As cannabis consumption is increasing globally, including among pregnant women, there is a critical need to understand the effects of cannabis on fetal development and birth outcomes. We had two objectives: to determine 1) the factors associated with self-reported cannabis use in the pre/early-pregnancy period, and 2) whether cannabis use is associated with low birth weight, preterm birth, or small size for gestational age (GA) infants. Cannabis use is rising globally, and has more than doubled among Canadians between 1985 and 2015 [1]. It is cited as the most commonly used illicit substance during pregnancy [2, 3]. While some existing studies have already presented a link between maternal cannabis use and adverse birth outcomes such as low birth weight and preterm birth, others continue to report no association [7, 8]. One of the biggest challenges in this research area lies in isolating the independent association between cannabis use and birth outcomes, given that many cannabis users use alcohol and tobacco concurrently [3].

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