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Health Equity/Community Health

Poster Session 4

(1109) THC Impact in Urine Drug Screens on Maternal and Neonatal Outcomes in Substance Use Disorder

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Evaluate the effects of tetrahydrocannabinol (THC) presence in urine drug screens (UDS) on neonatal and maternal outcomes in patients with substance use disorder.

Study Design: Prospective cohort study of pregnant patients enrolled in a multidisciplinary treatment program between 2015 and May 2023. Patients had at least 2 prenatal visits.  Unexpected UDS group contained at least 2 UDS positive for THC, while the control group had no UDS with THC. Primary outcomes included decreased birth weight, decreased head circumference, NICU admission, and NICU length of stay. Secondary outcomes assessed were tobacco use, Neonatal Abstinence Syndrome (NAS), a composite of various neonatal outcomes, prenatal care compliance, maternal obstetric outcomes, return to opioid use, and unexpected UDS. Categorical outcomes displayed counts, percentages and Fisher’s Exact test p-values. Quantitative outcomes showed summary stats with respective Poisson regression p-values or t-test. Analyses were done in SAS 9.4. 

Results:

382 patients enrolled in the multispecialty treatment program met inclusion and exclusion criteria. 114 of 382 (30%) had a positive UDS for THC vs 268 of 382 (70%) patients had no THC on any UDS. Tobacco use during pregnancy was similar in THC group 90% vs 84%, P=.316. Demographic data was similar including age at e-cigarette use and overdose history. 



Prenatal and Postnatal visit compliance was lower in THC group 57% ± 30% vs 77% ±28%, < .0001. Compliance was defined as the number of appropriate visits (without a positive UDS for any drugs) divided by the total number of potential visits). Mean Buprenorphine dose at delivery was similar for THC group 12 mg ± 4 vs no THC at 12 mg ± 4, P=.648. Maternal complications, GA at delivery, head circumference, birth weight, NOWS rates and NICU admissions were similar between groups, Table 1. 


Conclusion: The p</span>resence of THC in urine pregnancy tests of women with OUD did not appear to significantly affect maternal delivery complications, birth weight or head circumference. However, it was associated with lower compliance with prenatal and postnatal visits.