Association between maternal cannabis use and birth outcomes: an observational study

Michalski, Camilla A.; Hung, Rayjean J.; Seeto, Ryan A; Brooks, Jennifer; Henderson, Joanna; Levitan, Robert D.; Lye, Stephen J.; Matthews, Stephen G.; Knight, Julia A.

doi:10.1186/s12884-020-03371-3

Cited by 24 publications

(27 citation statements)

References 22 publications

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“…As few studies reported quantity, we used the classification of cannabis dependence or abuse or substance use disorder associated with cannabis as a proxy for intensive use. Only one study reported medical use, and the only pregnant women with medical use was excluded 24 . Therefore, we were not able to conduct this subgroup analyses.…”

Section: Data Synthesismentioning

confidence: 99%

“…Most studies did not present information regarding the type of cannabis use (medical or recreational use). Only three studies clearly stated that cannabis use was recreational 24,29,30 . The great majority of studies relied only on maternal self-report (n=14).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…The timing of self-report measurement varied between studies: during antenatal appointments 8,15,16,24,[31][32][33][34][35][36][37] ; at delivery 13,15,27,[38][39][40] ;or after delivery by telephone interview 14,[41][42][43] . Somestudies also included exposure to cannabis before pregnancy 14,24,42 . Eleven studies used maternal urine, hair or meconium test screening nine of them assessing cannabis exposure only once, either during pregnancy 8,15,16,29,30,4 or at the time of delivery 13,38,45 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

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The Effects of Cannabis Use during Pregnancy on Low Birth Weight and Preterm Birth: A Systematic Review and Meta-analysis

Baía

Domingues

2022

Am J Perinatol

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Objective: to summarize literature regarding the effects of cannabis use during pregnancy on low birthweight (LBW), preterm birth (PTB) and small for gestational age (SGA). Study Design: systematic review and meta-analysis. A literature search was conducted in PubMed, Scopus, EBSCO and Web of Science in May 2021 and updated in November 2021. Only studies that assessed the isolated use of cannabis during pregnancy, controlling for cigarette smoking and other illicit drug use, were included. Data was synthesized using a narrative summary and pooled adjusted estimates and 95% confidence intervals (CI) were calculated for each outcome. Data was analyzed using Stata 13.0 with METAN software package, using random effects. Statistical heterogeneity was assessed using the Cochran´s Q and Higgins I2 tests. Results: 32 studies were included with data from approximately 5.5 million women for the LBW outcome and 23 million for the PTB and SGA outcomes. Pregnant women using cannabis are at increased risk for LBW (aOR= 1.52; 95%CI= [1.18;1.96]), PTB (aOR= 1.39; 95%CI= [1.28;1.51]), and SGA (aOR= 1.47; 95%CI= [1.38;1.58]). Studies that assessed type of preterm birth and gestational age at birth indicate higher risks of spontaneous PTB and of early or very-early preterm births associated with cannabis use during pregnancy. The few studies that assessed the timing and frequency of consumption suggest a dose-response effect, with higher odds of negative outcomes among women who reported heavy use and with continued use during the second and third trimester of gestation. Conclusion: There is an effect of cannabis irrespectively of other illicit drugs and tobacco, despite high heterogeneity and low quality of evidence. There is a need to discuss public policies regarding cannabis’ regulation and how it influences its consumption. Future studies should focus on the effects of cannabis’s type (medicinal or recreational), timing and dosage during pregnancy on perinatal outcomes.

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Section: Data Synthesismentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

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The Effects of Cannabis Use during Pregnancy on Low Birth Weight and Preterm Birth: A Systematic Review and Meta-analysis

Baía

Domingues

2022

Am J Perinatol

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“…Alarmingly, gestational exposure to cannabis can increase the risk for adverse neonatal outcomes, including low birth weight and preterm delivery [ 6 , 7 , 8 ]. However, these studies are confounded by that fact that cannabis users are more likely to concurrently abuse other drugs, such as alcohol and tobacco [ 9 ], highlighting the need for animal studies that focus on the effects of specific constituents of cannabis (i.e., Δ9-tetrahydrocannabinol [Δ9-THC] and cannabidiol [CBD]) on short- and long-term maternal-fetal outcomes [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

In Utero Exposure to Δ9-Tetrahydrocannabinol Leads to Postnatal Catch-Up Growth and Dysmetabolism in the Adult Rat Liver

Oke

Lee

Papp

et al. 2021

IJMS

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The rates of gestational cannabis use have increased despite limited evidence for its safety in fetal life. Recent animal studies demonstrate that prenatal exposure to Δ9-tetrahydrocannabinol (Δ9-THC, the psychoactive component of cannabis) promotes intrauterine growth restriction (IUGR), culminating in postnatal metabolic deficits. Given IUGR is associated with impaired hepatic function, we hypothesized that Δ9-THC offspring would exhibit hepatic dyslipidemia. Pregnant Wistar rat dams received daily injections of vehicular control or 3 mg/kg Δ9-THC i.p. from embryonic day (E) 6.5 through E22. Exposure to Δ9-THC decreased the liver to body weight ratio at birth, followed by catch-up growth by three weeks of age. At six months, Δ9-THC-exposed male offspring exhibited increased visceral adiposity and higher hepatic triglycerides. This was instigated by augmented expression of enzymes involved in triglyceride synthesis (ACCα, SCD, FABP1, and DGAT2) at three weeks. Furthermore, the expression of hepatic DGAT1/DGAT2 was sustained at six months, concomitant with mitochondrial dysfunction (i.e., elevated p66shc) and oxidative stress. Interestingly, decreases in miR-203a-3p and miR-29a/b/c, both implicated in dyslipidemia, were also observed in these Δ9-THC-exposed offspring. Collectively, these findings indicate that prenatal Δ9-THC exposure results in long-term dyslipidemia associated with enhanced hepatic lipogenesis. This is attributed by mitochondrial dysfunction and epigenetic mechanisms.

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“…Alarmingly, gestational exposure to cannabis can increase the risk for adverse neonatal outcomes, including low birth weight and preterm delivery [6][7][8]. However, these studies are confounded by that fact that cannabis users are more likely to concurrently abuse other drugs such as alcohol and tobacco [9], highlighting the need for animal studies that focus on the effects of specific constituents of cannabis (i.e., Δ9tetrahydrocannabinol [Δ9-THC] and cannabidiol [CBD]) on short-and long-term maternal-fetal outcomes [9].…”

Section: Introductionmentioning

confidence: 99%

In Utero Exposure to 9-Tetrahydrocannabinol Leads to Postnatal Catch-up Growth and Dysmetabolism in the Adult Rat Liver

Oke¹,

Lee²,

Papp³

et al. 2021

Preprint

View full text Add to dashboard Cite

Rates of gestational cannabis use have increased despite limited evidence for its safety in fetal life. Recent animal studies demonstrate that prenatal exposure to 9-tetrahydrocannabinol (9-THC, the psychoactive component of cannabis) promotes intrauterine growth restriction (IUGR), culminating in postnatal metabolic deficits. Given IUGR is associated with impaired hepatic function, we hypothesized that 9-THC offspring would exhibit hepatic dyslipidemia. Pregnant Wistar rat dams received daily injections of vehicular control or 3 mg/kg 9-THC i.p. from embryonic day (E) 6.5 through E22. Exposure to 9-THC decreased the liver to body weight ratio at birth, followed by catch-up growth by three weeks of age. At six months, 9-THC-exposed male offspring exhibited increased visceral adiposity and higher hepatic triglycerides. This was instigated by augmented expression of enzymes involved in triglyceride synthesis (ACC, SCD, FABP1, and DGAT2) at three weeks. Furthermore, the expression of hepatic DGAT1/DGAT2 was sustained at six months, concomitant with mitochondrial dysfunction (i.e., elevated p66shc) and oxidative stress. Interestingly, decreases in miR-203a-3p and miR-29a/b/c, both implicated in dyslipidemia, was also observed in these 9-THC-exposed offspring. Collectively, these findings indicate that prenatal 9-THC exposure results in long-term dyslipidemia associated with enhanced hepatic lipogenesis. This is attributed by mitochondrial dysfunction and epigenetic mechanisms.

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Association between maternal cannabis use and birth outcomes: an observational study

Cited by 24 publications

References 22 publications

The Effects of Cannabis Use during Pregnancy on Low Birth Weight and Preterm Birth: A Systematic Review and Meta-analysis

The Effects of Cannabis Use during Pregnancy on Low Birth Weight and Preterm Birth: A Systematic Review and Meta-analysis

In Utero Exposure to Δ9-Tetrahydrocannabinol Leads to Postnatal Catch-Up Growth and Dysmetabolism in the Adult Rat Liver

In Utero Exposure to 9-Tetrahydrocannabinol Leads to Postnatal Catch-up Growth and Dysmetabolism in the Adult Rat Liver

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