American Journal on Addictions最新文献

Estimating the effects of prenatal cannabis exposure on birth outcomes. 估计产前接触大麻对出生结果的影响。

IF 2.5 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2024-09-05 DOI: 10.1111/ajad.13650

Alyssa Vanderziel, James C Anthony, David Barondess, Jean M Kerver, Omayma Alshaarawy

Background and objectives: Prenatal cannabis use prevalence in the United States has increased. Relaxation of state-level cannabis policy may be contributing to the diminished risk perception of using cannabis. The main psychoactive constituent of cannabis, delta-9-tetrahydrocannabinol, crosses the placenta, interacting with functional cannabinoid receptors in the fetus. Here, we assess the association between prenatal cannabis exposure (PCE) and a set of birth outcomes.

Methods: Using the Michigan Archive for Research on Child Health, a prospective pregnancy cohort, we linked prenatal survey data with neonatal data from state-archived birth records. Recruitment occurred in 23 clinics across Michigan. Pregnant participants with live birth records between October 2017 and January 2022, after exclusion for missing data on cannabis use, birth outcomes, and covariates, were included in the final analytic sample (n = 584). Analyses involved generalized linear models.

Results: An estimated 15% (95% confidence interval [CI]: 12%, 18%) of participants reported using cannabis during pregnancy. Covariate-adjusted models revealed an association between PCE and birth size (ß = -0.3; 95% CI: -0.5, -0.003).

Discussion and conclusions: Findings suggest a relationship between PCE and smaller birth size. Clinicians should follow guidelines outlined by the American College of Obstetricians and Gynecologists when counseling pregnant patients on cannabis use.

Scientific significance: We detected a significant association between PCE and birth size. Most studies focus only on the extremes of birth size, however, use of z-scores allow for assessment of the sex-specific birth weight-for-gestational age distribution, increasing the accuracy of detecting an effect of cannabis exposure on birth size.

背景和目的：美国产前使用大麻的流行率有所上升。州一级大麻政策的放宽可能是导致使用大麻的风险意识降低的原因之一。大麻的主要精神活性成分δ-9-四氢大麻酚会穿过胎盘，与胎儿体内的大麻素功能受体相互作用。在此，我们评估了产前大麻暴露（PCE）与一系列出生结果之间的关联：我们利用密歇根儿童健康研究档案这一前瞻性妊娠队列，将产前调查数据与州存档出生记录中的新生儿数据联系起来。我们在密歇根州的 23 家诊所进行了招募。2017年10月至2022年1月期间有活产记录的怀孕参与者，在排除大麻使用、出生结果和协变量数据缺失后，被纳入最终分析样本（n = 584）。分析采用广义线性模型：估计有 15%（95% 置信区间 [CI]：12%，18%）的参与者报告在怀孕期间使用过大麻。协变量调整模型显示 PCE 与出生大小之间存在关联（ß = -0.3；95% 置信区间：-0.5，-0.003）：讨论与结论：研究结果表明，PCE 与新生儿体型较小有一定关系。临床医生在指导孕妇使用大麻时，应遵循美国妇产科医师学会制定的指导方针：科学意义：我们发现 PCE 与新生儿体型之间存在明显关联。大多数研究只关注出生大小的极端值，然而，使用 z 值可以评估胎龄性别出生体重的分布情况，从而提高检测大麻暴露对出生大小影响的准确性。

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