Abstract
BackgroundA quarter of pregnant women use alcohol, 6.5/1000 deliveries are affected by opioid use disorder (OUD), and the prevalence of cannabis use in pregnant women is increasing. However, marijuana co-exposure in polysubstance-using women is not well described.MethodsThe well-characterized ENRICH-1 cohort (n = 251), which focused on the effects of two primary exposures of interest—opioids and alcohol, was used to (1) estimate the prevalence/frequency of marijuana use in those with OUD and/or alcohol use, and (2) examined correlates of marijuana use. Participants were classified into an OUD group (n = 125), Alcohol group (n = 69), and concurrent OUD and Alcohol (OUD + Alcohol) group (n = 57). Self-report and biomarkers ascertained substance use. Multivariable logistic regression identified correlates of marijuana use.ResultsThe prevalence of any marijuana use in pregnancy was 43.2%, 52.6%, and 46.4% in the OUD, OUD + Alcohol, and Alcohol groups, respectively. Correspondingly, weekly or daily use was reported by 19.4%, 21.0%, and 24.6% of participants. In the OUD and OUD + Alcohol groups, the proportion of women using marijuana was significantly higher in those taking buprenorphine (45.8% and 58.3%, respectively) compared to women using methadone (37.5% and 42.9%, respectively). Mean maternal age was lower in women who used marijuana in all three groups compared to non-marijuana users. Independent correlates of marijuana use (controlling for group, race/ethnicity, education, and smoking) were maternal age (adjusted Odds Ratio (aOR) per 5-year increment 0.61; (95% CI 0.47, 0.79)), and polysubstance use (aOR 2.02; 95% CI 1.11, 3.67). There was a significant interaction between partnership status and group: among women who were not in a partnership, those in the OUD and OUD + Alcohol groups had lower odds of marijuana use relative to the Alcohol group. For women in the Alcohol group, partnered women had lower odds of marijuana use than un-partnered women (aOR 0.12; 95% CI: 0.02, 0.68).ConclusionsResults indicate a relatively high prevalence and frequency of marijuana use in pregnant women being treated for OUD and/or women consuming alcohol while pregnant. These results highlight the need for ongoing risk reduction strategies addressing marijuana use for pregnant women receiving OUD treatment and those with alcohol exposure.
Highlights
The opioid epidemic in the U.S has affected people across the lifespan, including pregnant women and newborn children
Numerous studies have demonstrated associations between prenatal opioid exposure and intrauterine growth restriction (IUGR), preterm delivery, and stillbirth [5]. It is unclear if prenatal opioid exposure, medications for the treatment of opioid use disorder (OUD) (MOUD), neonatal opioid withdrawal syndrome (NOWS), and/or treatment for NOWS are associated with poor long-term neurodevelopmental outcomes or if adverse outcomes are primarily driven by adverse pre- and postnatal environmental factors
The prevalence of marijuana use among pregnant women with OUD and some alcohol use in this study was twice that reported by people with a chronic medical condition surveyed in the 2016 and 2017 Behavioral Risk Factor Surveillance System (BRFSS): 21.9% of those aged 18–34 with any chronic condition reported marijuana use versus 13.1% of people surveyed with no medical condition [32]
Summary
The opioid epidemic in the U.S has affected people across the lifespan, including pregnant women and newborn children. Numerous studies have demonstrated associations between prenatal opioid exposure and intrauterine growth restriction (IUGR), preterm delivery, and stillbirth [5] It is unclear if prenatal opioid exposure, medications for the treatment of OUD (MOUD), neonatal opioid withdrawal syndrome (NOWS), and/or treatment for NOWS are associated with poor long-term neurodevelopmental outcomes or if adverse outcomes are primarily driven by adverse pre- and postnatal environmental factors. A recent study demonstrated that infants with NOWS are at increased risk of unplanned healthcare utilization during the first year of life [8] A key challenge in assessing obstetric and neonatal outcomes is the need to fully account for the effects of polydrug use, i.e., co-exposure with marijuana, alcohol, stimulants, or other substances. Marijuana co-exposure in polysubstance-using women is not well described
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
