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Health Equity/Community Health

Poster Session 1

(226) Family Separation at Birth: Impact of marijuana-only positive urine drug screening on the parent-neonatal dyad

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: This study described and compared the neonatal outcomes and interventions for pregnant patients with a positive marijuana-only UDS compared to those with a negative UDS after implementation of a urine drug screening protocol.

Study Design: This is a retrospective cohort study comparing pregnant patients with a positive marijuana-only UDS result and those with a negative UDS admitted to the labor floor from 9/1/2020 to 6/1/2022. Patient demographics and neonatal outcomes were collected from the electronic medical record (Table 1). Chi square analysis was used to evaluate the association between categorical variables.

Results: Of 7022 births during the study period, 127 (1.8%) patients had a UDS collected. Patients who identified as Black were significantly more likely to have a UDS collected (P< 0.0001). Of the 127 patients with a UDS result, 55 (43%) had a negative UDS, 28 (22%) had a marijuana-only positive result, 44 were positive for other substances (34.6%). Of the patients with marijuana-only positive results, 12 were sent for no prenatal care, 1 for altered mental status, 4 for use of illicit substances, 3 for treatment with medications for opioid use disorder, 1 for suspicion of abruption, 4 for intrauterine fetal demise, and 1 undocumented indication. There was no difference in neonatal outcomes between the two groups, however, significantly more in the marijuana only group were referred to DHS (44% versus 16%). Of the 28 patients with marijuana-only results with a DHS referral, 4 were discharged home without custody of their neonates.

Conclusion:

No significant differences in neonatal outcomes were observed between patients with and without a positive marijuana-only UDS result. Nonetheless, current UDS testing practices have significant adverse impact on parent-baby dyad and may lead to family separation and its associated downstream health effects. Given the legality of marijuana in much of the U.S., and its lack of medical significance, we recommend that its detection should be removed from the UDS for birthing parents.