JOGC

Cannabis Abuse or Dependence During Pregnancy: A Population-Based Cohort Study on 12 Million Births

Published:November 14, 2018DOI:https://doi.org/10.1016/j.jogc.2018.09.009

      Abstract

      Objective

      Cannabis is the most commonly used recreational drug during pregnancy in the United States. This study aimed to describe the rate of cannabis dependence or abuse use during pregnancy and its effect on obstetrical and neonatal outcomes.

      Methods

      A retrospective population-based cohort of births in the United States between 1999 and 2013 was created using data from the National Inpatient Sample. Births to mothers who reported cannabis dependence or abuse were identified using ICD-9 codes, and the effect on various obstetrical and neonatal outcomes was assessed using logistic regression, adjusting for relevant confounders (Canadian Task Force Classification II-2).

      Results

      A total of 12 578 557 births were included in our analysis. The incidence of cannabis abuse or dependence rose from 3.22 in 1000 births in 1999 to 8.55 in 1000 births in 2013 ( P < 0.0001). Women reporting cannabis dependence or abuse were more likely to have a preterm premature rupture of membranes (odds ratio [OR] 1.46; 95% confidence interval [CI] 1.35–1.58), a hospital stay of >7 days (OR 1.17; 95% CI 1.11–1.23), and an intrauterine fetal demise (OR 1.50; 95% CI 1.39–1.62). Neonates born to exposed mothers had a higher risk of prematurity (OR 1.40; 95% CI 1.36–1.43) and growth restriction (OR 1.35; 95% CI 1.30–1.41).

      Conclusion

      Cannabis use during pregnancy steadily increased over the study period. Users of cannabis during gestation were more likely to have adverse outcomes during delivery and require longer periods of hospitalization. Neonates born to exposed mothers were more likely to be born preterm and underweight.

      Résumé

      Objectif

      Aux États-Unis, le cannabis est la drogue à usage récréatif la plus fréquemment consommée pendant la grossesse. Cette étude avait pour buts de calculer le taux de femmes enceintes ayant une dépendance au cannabis ou abusant de celui-ci et de présenter l’incidence du cannabis sur les issues obstétricales et néonatales.

      Méthodologie

      Une étude de cohorte rétrospective basée sur la population et portant sur les naissances survenues aux États-Unis entre 1999 et 2013 a été menée au moyen de données issues du National Inpatient Sample. Les naissances issues de mères ayant déclaré être dépendantes aux cannabis ou avoir abusé de celui-ci ont été codées selon la CIM-9, et les effets du cannabis sur les diverses issues obstétricales et néonatales ont été évalués au moyen de régressions logistiques tenant compte des facteurs de confusion potentiels (classification II-2 du Groupe d’étude canadien).

      Résultats

      Au total, 12 578 557 naissances ont été retenues pour l’analyse. L’incidence de la dépendance au cannabis ou de l’abus de celui-ci est passée de 3,22 par 1 000 naissances en 1999 à 8,55 par 1 000 naissances en 2013 ( P < 0,0001). Les femmes dépendantes au cannabis ou ayant abusé de celui-ci étaient plus susceptibles de vivre une rupture prématurée des membranes (RC : 1,46; IC à 95 % : 1,35–1,58), d’être hospitalisées plus de sept jours (RC : 1,17; IC à 95 % : 1,11–1,23) et de présenter un décès fœtal intra-utérin (RC : 1,50; IC à 95 % : 1,39–1,62). Les nouveau-nés de mères exposées au cannabis couraient un risque accru de naissance prématurée (RC : 1,40; IC à 95 % : 1,36–1,43) et de retard de croissance (RC : 1,35; IC à 95 % : 1,30–1,41).

      Conclusion

      La consommation de cannabis pendant la grossesse a augmenté de façon constante au cours de la période à l’étude. Les femmes enceintes qui en consommaient couraient un risque accru d’hospitalisation prolongée et d’issues indésirables à l’accouchement. Les nouveau-nés de mères exposées au cannabis étaient plus susceptibles de naître prématurément et de présenter un poids insuffisant.

      Key Words

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