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Clinical Obstetrics

Poster Session 2

(423) Cannabis use and development of hypertension in the nuMoM2b Heart Health Study

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Cannabis use is increasing among reproductive age people with largely unknown health effects. Prior research demonstrates an association between cannabis use and hypertension (HTN). We aimed to quantitatively evaluate if cannabis exposure after pregnancy is associated with incident HTN 2-7 years after pregnancy.

Study Design: Secondary analysis of the nuMoM2b Heart Health Study. Nulliparous participants were followed from the first trimester of their index pregnancy to an in-person study visit 2-7 years after their pregnancy for development of adverse cardiovascular outcomes. The primary outcome was incident stage II HTN (systolic blood pressure ≥140 or diastolic blood pressure ≥90) or use of an antihypertensive agent at the time of the 2-7 year follow up visit. The primary exposure was cannabis exposure after pregnancy defined as urine positive for THC-COOH (11-nor-9-carboxy-delta-9-tetrahydrocannabinol) metabolite (cutoff ≥15 ng/ml) at the 2-7 year study visit.  A multivariable logistic regression model was fit and adjusted for covariates that were selected a priori including nicotine exposure assessed at the 2-7 year visit (measured via serum cotinine levels or self-report), and occurrence of any adverse pregnancy outcome (APO), race/ethnicity, area deprivation index, maternal age, and diabetes mellitus at the time of the index pregnancy.

Results:

Of 4079 participants, 406 (9.95%) had exposure to cannabis and 216 (5.30%) developed HTN by the 2-7 year study visit (mean (SD) time to follow up: 3.2 (0.9) years). Neither cannabis (aOR 1.05, 95% CI 0.63-1.76) nor active nicotine (aOR 1.03, 95% CI 0.66-1.63) exposure were associated with incident HTN in multivariable modeling (Table). Factors collected at the index pregnancy that were associated with incident HTN included maternal age, index pregnancy APO, Black race, Hispanic ethnicity, and pregestational and gestational diabetes (Table).

Conclusion:

Cannabis exposure following pregnancy was not associated with incident HTN within 2-7 years after controlling for nicotine exposure and known risk factors measured during the first pregnancy.