Marijuana use and pregnancy: prevalence, associated characteristics, and birth outcomes
- 2.5k Downloads
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.
KeywordsMarijuana Pregnancy Birth outcomes
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.
- 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
- 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
- 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
- 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
- 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