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Clinical Obstetrics

Poster Session 2

(617) Associations between Isolated Prenatal Cannabis Use and Outcomes: A Prospective Cohort Study

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Foundation Awardee
Objective: Despite data linking prenatal cannabis use (PCU) to adverse childhood outcomes, use in pregnancy is rising.  Studies are often confounded by tobacco use, a known risk factor for maternal antenatal morbidity and small for gestational age (SGA). We sought to assess antenatal and birthweight outcomes of patients with isolated PCU.

Study Design: We performed a prospective cohort study of patients with pre-pregnancy cannabis use who were enrolled in the first trimester.  Patients were not eligible if they self-reported tobacco use; patients were then followed with serial urine cotinine testing and excluded from final analysis if positive. P</span>rimary outcomes were SGA < 10th percentile and preeclampsia.  Secondary outcomes included gestational hypertension, gestational diabetes, fetal growth restriction, preterm birth, mode of delivery, SGA < 5th percentile, large for gestational age (LGA), and 5-minute APGAR < 7.  Descriptive statistics were used to compare baseline characteristics and backwards stepwise logistic regression was used to control for potential confounding.

Results: 366 patients were enrolled: 235 PCU and 131 controls. After serial urine drug screening with exclusion for cotinine positivity (42% of PCU and 10% of controls), and crossover between groups, a total of 131 PCU and 125 controls remained. Patients with PCU were younger (25 vs 27 yrs, p=0.03), had lower BMI (27 vs 31 kg/m2, p=0.00), and were less likely to identify as Hispanic (1.5% vs 7.26%, p=0.02).  Isolated PCU was not associated with preeclampsia (17% PCU vs. 14% control; aRR 1.36; 95% CI 0.62-2.63), SGA (15% vs. 11%; aRR 0.79; 95% CI 0.36-1.59), or any of the secondary maternal outcomes (Table 1). PCU was associated with a decreased risk of LGA in unadjusted analysis (5% vs. 14%; RR 0.33; 95% CI 0.13-0.83); this result was attenuated after adjustment (aRR 0.94; 95% CI 0.23-3.33).

Conclusion: Isolated PCU was not associated with differences in maternal or neonatal adverse pregnancy outcomes, consistent with prior literature. Additional study is ongoing to assess cannabis-specific outcomes in the newborn and early childhood periods.