在美国(US),怀孕期间的大麻使用障碍(CUD)急剧增加。这项研究调查了产前CUD与不良新生儿结局之间的关联以及母亲烟草使用状况和种族/民族之间的异质性。
以人口为基础,回顾性队列研究。
加州,美国。
在2001年至2012年期间,共有483万母亲分娩了单胎和配对婴儿。数据来自母婴相关的出院记录以及出生和死亡证明。由交付时记录的ICD-9代码识别,20237名母亲有产前CUD。
新生儿结局包括妊娠期,早产,出生体重,入住新生儿重症监护室,出生后1年内住院,出生后一年内死亡。倾向评分匹配用于平衡产妇,父系,以及暴露于产前CUD和未暴露于CUD的婴儿之间的比较中的婴儿特征。
在2001年至2012年期间,每1000次交付的CUD从2.8增加到6.9。匹配样本的多变量回归估计,产前CUD与更大的小于胎龄的几率相关(OR=1.13,95%CI=1.08,1.18),早产(OR=1.06,95%CI=1.01,1.12),低出生体重(OR=1.13,95%CI=1.07,1.20),出生后1年内死亡(OR=1.35,95%CI=1.12,1.62)。与母亲不使用烟草的婴儿相比,母亲是烟草使用者的婴儿早产的几率更大,低出生体重,住院治疗,以及与产前CUD相关的死亡。与母亲是非西班牙裔白人的婴儿相比,母亲为西班牙裔的婴儿住院和死亡的几率更大,母亲为非西班牙裔黑人的婴儿与产前CUD相关的小于胎龄的几率更大.
产前使用大麻障碍似乎与新生儿主要不良结局的几率上升有关。母亲的烟草使用状况和种族/族裔之间的关联具有异质性。
Cannabis use disorder (CUD) during pregnancy has increased dramatically in the United States (US). This study examined the associations between prenatal CUD and adverse neonatal outcomes and heterogeneities in the associations by mothers\' tobacco use status and race/ethnicity.
Population-based, retrospective cohort study.
California, USA.
A total of 4.83 million mothers who delivered a live singleton birth during 2001 to 2012 and their paired infants. Data were obtained from mother-infant linked hospital discharge records and birth and death certificates. Identified by ICD-9 codes recorded at delivery, 20 237 mothers had prenatal CUD.
Neonatal outcomes included length of gestation, preterm birth, birth weight, admission into neonatal intensive care unit, hospitalization within 1 year of birth, and death within 1 year of birth. Propensity score matching was used to balance maternal, paternal, and infant characteristics in the comparisons between infants exposed and unexposed to prenatal CUD.
CUD increased from 2.8 to 6.9 per 1000 deliveries during 2001 to 2012. Multivariable regressions in matched samples estimated that prenatal CUD was associated with greater odds of being small for gestational age (OR = 1.13, 95% CI = 1.08, 1.18), preterm birth (OR = 1.06, 95% CI = 1.01, 1.12), low birth weight (OR = 1.13, 95% CI = 1.07, 1.20), and death within 1 year of birth (OR = 1.35, 95% CI = 1.12, 1.62). Compared with infants whose mothers were tobacco non-users, infants whose mothers were tobacco users had greater odds of preterm birth, low birth weight, hospitalization, and death in association with prenatal CUD. Compared with infants whose mothers were non-Hispanic White, infants whose mothers were Hispanic had greater odds of hospitalization and death and infants whose mothers were non-Hispanic Black had greater odds of being small for gestational age in association with prenatal CUD.
Prenatal cannabis use disorder appears to be associated with escalated odds of major adverse neonatal outcomes, with heterogeneities in the associations by mothers\' tobacco use status and race/ethnicity.