Association between maternal cannabis use and birth outcomes: an observational study
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(2020) 20:771
RESEARCH ARTICLE
Open Access
Association between maternal cannabis use and birth outcomes: an observational study Camilla A. Michalski1* , Rayjean J. Hung1,2, Ryan A. Seeto2, Cindy-Lee Dennis3,4, Jennifer D. Brooks1, Joanna Henderson5,6, Robert Levitan5,6,7, Stephen J. Lye2, Stephen G. Matthews2,7,8,9 and Julia A. Knight1,2
Abstract Background: As cannabis consumption is increasing globally, including among pregnant women, there is a critical need to understand the effects of cannabis on fetal development and birth outcomes. We had two objectives: to determine 1) the factors associated with self-reported cannabis use in the pre/early-pregnancy period, and 2) whether cannabis use is associated with low birth weight, preterm birth, or small size for gestational age (GA) infants. Methods: Maternal questionnaire and birth outcome data was gathered from 2229 women and 1778 singleton infants in the Ontario Birth Study, a hospital-based prospective cohort study (2013–2019). Women self-reported cannabis use within 3 months of learning their pregnancy status. Multivariable linear and logistic regression was conducted to 1) identify factors associated with cannabis use, and 2) determine the associations between cannabis use with the selected birth outcomes. Results: Cannabis use increased in the cohort over time. Women who reported cannabis use (N = 216) were more likely to be younger and more likely to use alcohol, tobacco, and prescription pain medication, although most did not. These women had infants born at lower average birth weights and had 2.0 times the odds of being small for GA (95% confidence interval: 1.3, 3.3) after multivariable adjustment for socioeconomic factors and other substance use. Conclusion: Our results suggest that women who use cannabis around the time of conception have higher odds of having infants that are small for gestational age. Targeted clinical messaging may be most applicable to women actively trying to conceive. Keywords: Cannabis, Marijuana, Epidemiology, Canada, Women, Pregnancy, Small for gestational age, Birth weight
Background Cannabis use is rising globally, and has more than doubled among Canadians between 1985 and 2015 [1]. It is also cited as the most commonly used illicit substance during pregnancy [2, 3]. Studies have shown cannabis use to be highest in early first trimester, followed by substantial drop-off as the pregnancy progresses [4, 5]. As consumption gains social acceptance, and in light of * Correspondence: [email protected] 1 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Full list of author information is available at the end of the article
evidence that suggests endocannabinoid involvement in early reproductive events [6], pregnant women and their children stand to benefit from targeted research concerning birth outcome effects of prenatal cannabis use. While some existing studies have already presented a link between maternal cannabis use and adverse birth outcomes such as low birth weight and preter
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