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Epidemiology

Poster Session 3

(645) Perinatal effects of maternal cannabis and nicotine co-use in pregnancy

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Foundation Awardee
Objective: Prenatal cannabis use in the United States is rising and half of pregnant individuals who use cannabis also use nicotine-products. However, there is limited data regarding the combined effects of both cannabis and nicotine-products on perinatal outcomes. This study aims to assess the perinatal outcomes associated with prenatal cannabis and nicotine-product co-use, and use of either substance alone.

Study Design: This is a retrospective cohort study of California linked hospital discharge-vital statistics data from 2012-2019. We included singleton, live-born infants with gestational age of 23-42 weeks. Pregnant individuals were classified into four categories: no-use (neither cannabis nor nicotine; reference group), cannabis use only, nicotine-product use only, and co-use (use of both cannabis and nicotine-products). Chi-squared and multivariable logistic regression were utilized for statistical analyses.

Results: A total of 3,356,676 pregnant individuals were included: 25,168 used cannabis only, 62,199 used nicotine-products only and 11,401 co-used cannabis and a nicotine-product during pregnancy. After adjusting for maternal demographics, with ‘no-use’ as the reference group, hypertensive disease was significantly higher in patients with cannabis use (aOR=1.33; 95% CI: 1.27, 1.38), nicotine use (aOR=1.09 (1.06, 1.12) and co-use of cannabis and nicotine (aOR=1.13 (1.07, 1.22). Similarly, preterm delivery (<37 weeks and < 32 weeks) and severe maternal morbidity were higher with cannabis or nicotine use, but not with co-use. Neonatal outcomes including NICU admission, small for gestational age, respiratory distress syndrome, infant deaths, and others were also higher with cannabis and nicotine use (Table 1).

Conclusion: Our study suggests that prenatal cannabis and nicotine-products, both independently and with co-use are associated with increased odds of maternal and neonatal morbidity compared to non-users. Given the growing prevalence of prenatal cannabis and nicotine co-use, our findings can help guide provider counseling.