Abstract
Objective
This study sought to determine the association between cannabis use in pregnancy and
stillbirth, small for gestational age (SGA) (<10th percentile), and spontaneous preterm
birth (<37 weeks).
Methods
The study used abstracted obstetrical and neonatal medical records for deliveries
in British Columbia from April 1, 2008 to March 31, 2016 that were contained in the
Perinatal Data Registry of Perinatal Services British Columbia. Chi-square tests were
conducted to compare maternal sociodemographic characteristics by cannabis use. Logistic
regression was conducted to determine the association between cannabis use and SGA
and spontaneous preterm births. Cox proportional hazards regression modelling was
used to identify the association between cannabis use and stillbirth. Secondary analyses
were conducted to ascertain differences by timing of stillbirth (Canadian Task Force
Classification II-2).
Results
Maternal cannabis use has increased in British Columbia over the past decade. Pregnant
women who use cannabis are younger and more likely to use alcohol, tobacco, and illicit
substances and to have a history of mental illness. Using cannabis in pregnancy was
associated with a 47% increased risk of SGA (adjusted OR 1.47; 95% CI 1.33–1.61),
a 27% increased risk of spontaneous preterm birth (adjusted OR 1.27; 95% CI 1.14–1.42),
and a 184% increased risk of intrapartum stillbirth (adjusted HR [aHR] 2.84; 95% CI
1.18–6.82). The association between cannabis use in pregnancy and overall stillbirth
and antepartum stillbirth did not reach statistical significance, but it had comparable
point estimates to other outcomes (aHR 1.38; 95% CI 0.95–1.99 and aHR 1.34; 95% CI
0.88–2.06, respectively).
Conclusion
Cannabis use in pregnancy is associated with SGA, spontaneous preterm birth, and intrapartum
stillbirth.
Résumé
Objectif
Cette étude visait à déterminer s'il y a une association entre la consommation de
cannabis pendant la grossesse et la mortinaissance, la petite taille pour l’âge gestationnel
(< 10e centile) et la naissance prématurée spontanée (< 37 semaines).
Méthodologie
Nous nous sommes servis de données obstétricales et néonatales extraites des dossiers
médicaux de femmes ayant accouché en Colombie-Britannique entre le 1er avril 2008 et le 31 mars 2016. Les données sont tirées du Perinatal Data Registry
des services périnataux de la Colombie-Britannique. Un test du chi carré a été effectué
pour comparer les caractéristiques sociodémographiques des mères selon leur consommation
de cannabis, et une régression logistique a servi à déterminer s'il y avait une association
entre la consommation de cannabis et la petite taille pour l’âge gestationnel ou la
naissance prématurée spontanée. Un modèle de régression de Cox a été utilisé pour
établir une association entre la consommation de cannabis et la mortinaissance. Des
analyses secondaires ont été effectuées pour évaluer les différences en fonction du
moment de la mortinaissance (classification II-2 du Groupe d’étude canadien).
Résultats
Au cours des 10 dernières années, la consommation de cannabis pendant la grossesse
a augmenté en Colombie-Britannique. Les femmes enceintes qui consomment du cannabis
sont plus jeunes qu'avant et sont plus susceptibles de consommer de l'alcool, du tabac
et des substances illicites ou d'avoir des antécédents de troubles de santé mentale.
La consommation de cannabis pendant la grossesse a été associée à un risque accru
de petite taille pour l’âge gestationnel de l'ordre de 47 % (RC ajusté : 1,47; IC
à 95 % : 1,33–1,61), à un risque accru de naissance prématurée spontanée de l'ordre
de 27 % (RC ajusté : 1,27; IC à 95 % : 1,14–1,42) et à un risque accru de mortinaissance
intrapartum de l'ordre de 184 % (RR ajusté [RRA] : 2,84; IC à 95 % : 1,18–6,82). Ni
l'association entre la consommation de cannabis pendant la grossesse et le taux global
de mortinaissances, ni celle entre la consommation pendant la grossesse et la mortinaissance
antepartum n’étaient significatives, mais leurs estimations ponctuelles étaient comparables
à celles des autres issues (RRA : 1,38; IC à 95 % : 0,95–1,99; et RRA : 1,34; IC à
95 % : 0,88–2,06, respectivement).
Conclusion
La consommation de cannabis pendant la grossesse est associée à une petite taille
pour l’âge gestationnel, à la naissance prématurée spontanée et à la mortinaissance
intrapartum.
Key Words
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Article info
Publication history
Published online: February 07, 2019
Footnotes
Competing interests: See Acknowledgements.
Each author has indicated that they meet the journal's requirements for authorship.
Identification
Copyright
© 2018 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
