(789) Perinatal Cannabis Use Adversely Impacts Pregnancy and Neonatal Outcomes

Cannabis use in pregnancy has been markedly rising. There is an existing gap in knowledge regarding the safety of prenatal cannabis use, partly because prior studies had either small sample size or did not adjust for potential cofounders. The purpose of this study is to examine recent data from a large, population-based birth cohort to understand the impact of maternal cannabis use on perinatal outcomes.

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. Our maternal outcomes of interest included hypertensive disease, preterm delivery (PTD) of < 37 weeks & < 32 weeks), severe maternal morbidity (SMM). As blood transfusion is the major contributor to SMM, we also examined non-transfusion SMM. Neonatal outcomes included NICU admission, small for gestational age (SGA), respiratory distress syndrome (RDS), and infant death. Chi-squared and multivariable logistic regression were utilized for statistical analyses.

Results:

A total of 3,551,167 pregnant people were included. 37,417 (1.05%) had a cannabis related diagnosis at delivery. Patients with cannabis related diagnosis were more likely to experience SMM (aOR 1.35; 99% CI: 1.26,1.46), non-transfusion SMM (aOR 1.40; 99% CI:1.24, 1.58), PTD< 37 weeks (aO 1.68; 99% CI:1.62, 1.73), PTD< 32 weeks (aOR 1.86; 99% CI:1.73, 2.00) and hypertensive disease (aOR1.36; 99% CI: 1.31, 1.40). Neonatal outcomes were also significantly higher for those with a cannabis related diagnosis (Table), including NICU admission (aOR 1.43; 99% CI: 1.39, 1.47), SGA (aOR1.48;1.43, 1.52), RDS (aOR 1.50; 99% CI: 1.43, 1.57), and infant death (aOR 1.93; 99% CI:1.69, 2.20).  

Conclusion:

Our study suggests that use of prenatal cannabis is associated with increased odds of maternal and neonatal morbidity. Given the legislative changes to cannabis legalization and the prevalence of use, our results can inform prenatal care and counseling.