Advertisement

Archives of Women's Mental Health

, Volume 19, Issue 1, pp 105–111 | Cite as

Marijuana use and pregnancy: prevalence, associated characteristics, and birth outcomes

  • Katrina MarkEmail author
  • Andrea Desai
  • Mishka Terplan
Original Article

Abstract

This study examines the prevalence, behaviors, and birth outcomes associated with marijuana use in pregnancy. This was a retrospective cohort from a university-based prenatal care clinic from July 1, 2009 to June 30, 2010. The primary exposure was marijuana use, defined by self-report or urine toxicology. Demographic and outcome data were determined by chart review and analyzed by chi-square test, Fisher’s exact test, ANOVA, and logistic regression. Three hundred and ninety-six patients initiated prenatal care during this time frame; 116 (29.3 %) of whom screened positive for marijuana at initial visit. Patients who used marijuana were less likely to have graduated high school (p = 0.016) or be employed (p = 0.015); they were more likely to use tobacco (p < 0.001) or alcohol (p = 0.032) and report a history of abuse (p = 0.010) or depressed mood (p = 0.023). When analyzed via logistic regression, only tobacco use remained associated with marijuana use (adjusted odds ratio (OR) = 3.3; 95 % confidence interval (CI): 1.9–5.9). Birth outcomes were available for 170 (43.0 %) patients. Only 3 (1.9 %) tested positive for marijuana at the time of delivery. Marijuana use was not related to incidence of low birth weight (13.8 % vs 14.0 %, p = 1.00), preterm delivery (17.7 % vs 12.0 %, p = 0.325), or NICU admissions (25.5 % vs 15.8 %, p = 0.139). Prenatal care utilization was equal between marijuana users and non-users. Although marijuana is common among obstetric patients at prenatal care initiation, most cease use by delivery. Marijuana is strongly correlated with cigarette use. We found no differences in birth outcomes or utilization of prenatal care by marijuana exposure.

Keywords

Marijuana Pregnancy Birth outcomes 

Notes

Author descriptions

Mishka Terplan MD MPH FACOG Diplomate ABAM

Mishka Terplan is board certified in both Obstetrics and Gynecology and Addiction Medicine. He is currently the Medical Director of Behavioral Health System Baltimore, a non-profit organization coordinating much of the addiction treatment in the city.

Katrina S Mark MD

Katrina Mark is a Board Certified Obstetrician and Gynecologist at the University of Maryland School of Medicine. She is the Medical Director of the Women’s Health Clinic and participates in a multi-disciplinary group that coordinates care for pregnant women with addictions.

Andrea Desai MD

Andrea Desai is a fourth year resident in Obstetrics and Gynecology at the University of Maryland. She has been accepted into a fellowship in Maternal/Fetal Medicine.

References

  1. Academy of Breast Feeding Medicine. Clinical Protocol #21: Guidelines for breastfeeding and the drug dependent women. Available at: http://www.bfmed.org/Media/Files/Protocols/Protocol%2021%20English.pdf. Accessed 8 Aug 2014
  2. American College of Obstetricians and Gynecologists (2011) Substance abuse reporting and pregnancy: the role of the obstetrician–gynecologist. Committee opinion no. 473. Obstet Gynecol 117:200–201CrossRefGoogle Scholar
  3. Burns L, Mattick R, Cooke M (2006) The use of record linkage to examine illicit drug use in pregnancy. Addiction 101:873–882CrossRefPubMedGoogle Scholar
  4. Cox S, Johnson C, Meikle S, Jamieson D, Posner S (2007) Trends in rates of hospitalization with a diagnosis of substance abuse among reproductive-age women, 1998–2003. Womens Health Issues 17:75–83CrossRefPubMedGoogle Scholar
  5. Ebrahim SH, Gfroerer J (2003) Pregnancy-related substance use in the United States during 1996–1998. Obstet Gynecol 101:374–379CrossRefPubMedGoogle Scholar
  6. El Marroun H, Tiemeier H, Steegers EA, Jaddoe VW, Hofman A, Verhulst FC (2009) Intrauterine cannabis exposure affects fetal growth trajectories: the Generation R Study. J Am Acad Child Adolesc Psychiatry 48:1173–1181CrossRefPubMedGoogle Scholar
  7. El-Mohandes A, Herman AA, Nabil El-Khorazaty M, Katta PS, White D, Grylack L (2003) Prenatal care reduces the impact of illicit drug use on perinatal outcomes. J Perinatol 23:354–360CrossRefPubMedGoogle Scholar
  8. Huizink AC (2014) Prenatal cannabis exposure and infant outcomes: overview of studies. Prog Neuropsychopharmacol Biol Psychiatry 3:45–52CrossRefGoogle Scholar
  9. Hyatbakhsh M, Flenady V, Gibbons K, Kingsbury A, Hurrion E, Mamun A, Najman J (2013) Birth outcomes associated with cannabis use before and during pregnancy. Pediatr Res 71:215–219CrossRefGoogle Scholar
  10. Kotelchuck M (1994) An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index. Am J Public Health 84:1414–1420. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1615177/?page=1. Accessed 8 Aug 2014
  11. Kramer M, Seguin L, Lydon J, Goulet L (2000) Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol 14:194–210CrossRefPubMedGoogle Scholar
  12. Lester B, ElSohly M, Wright L, Smeriglio V, Verter J, Bauer C, Shankaran S, Bada H, Walls H, Huestis M, Finnegan L, Maza P (2001) The Maternal Lifestyle Study: drug use by meconium toxicology and maternal self-report. Pediatrics 107:309–317CrossRefPubMedGoogle Scholar
  13. McCabe J, Arndt S (2012) Demographic and substance abuse trends among pregnant and nonpregnant women: eleven years of treatment admission data. Matern Child Health J 16:1696–1702CrossRefPubMedGoogle Scholar
  14. Moore D, Turner J, Parrot A, Goodwin J, Fulton S, Min M, Fox H, Braddick F, Axelsson E, Lynch S, Ribeiro H, Frostick C, Singer L (2010) During pregnancy, recreational drug-using women stop taking ecstasy (3,4-methylenedioxy-N-methylamphetamine) and reduce alcohol consumption, but continue to smoke tobacco and cannabis: initial findings from the Development and Infancy Study. J Psychopharmacol 24:1403–1410PubMedCentralCrossRefPubMedGoogle Scholar
  15. Shiono P, Klebenoff M, Nugent R, Cotch M, Wilkins D, Rollins D, Carey J, Berhman R (1995) The impact of cocaine and marijuana use on low birth weight and preterm birth: a multi-center study. Am J Obstet Gynecol 172:19–27CrossRefPubMedGoogle Scholar
  16. Substance Abuse and Mental Health Services Administration (2013) Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13–4795. Rockville, MD: Substance Abuse and Mental Health Services Administration. Available at: http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm#ch2.6. Accessed 8 Aug 2014
  17. Van Gelder M, Reefhuis J, Cayton A, Weirler M, Druschel C, Roeleveld N (2010) National Birth Defects Prevention Study. Drug Alcohol Depend 109:243–247CrossRefPubMedGoogle Scholar
  18. Varner M, Silver R, Rowland Hogue C, Willinger M, Parker C, Thorsten V, Goldenberg R, Saade G, Dudley D, Coustan D, Stoll B, Bukowsi R, Koch M, Conway D, Pinar H, Reddy U, Eunice Kennedy Shriver National Institute of Child Health and Human Development Stillbirth Collaborative Research Network (2014) Association between stillbirth and illicit drug use and smoking during pregnancy. Obstet Gynecol 123:113–125PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  1. 1.Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Department of Obstetrics, Gynecology and Reproductive Sciences, Department of Epidemiology and Public HealthUniversity of Maryland School of MedicineBaltimoreUSA
  3. 3.Behavioral Health System BaltimoreBaltimoreUSA

Personalised recommendations