Maternal Marijuana Use During Pregnancy, Marijuana Legalization, and Adverse Obstetrical and Neonatal Outcomes: A 12-year Cohort Study

母亲在怀孕期间吸食大麻、大麻合法化以及不良产科和新生儿结局：一项为期 12 年的队列研究

• 批准号: 10396031
• 负责人: Lyndsay Ammon Avalos
• 金额: $ 62.55万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10396031
• 关键词: Abruptio Placentae; Accounting; Adolescent; Affect; Antiemetics; Biochemical; California; Cannabinoids; Caring; Cesarean section; Child Welfare; Clinical; Clinical Data; Clinical Trials; Cohort Studies; Collection; Commerce; Communities; Conflict (Psychology); Congenital Abnormality; Data; Drug Exposure; Drug usage; Education; Electronic Health Record; Epidemiology; Fetal Death; Fetal Development; Fetal Growth Retardation; Fetal health; First Pregnancy Trimester; Future; Geography; Gold; Health; High Risk Woman; Income; Infant; Intervention Studies; Legal; Literature; Longitudinal cohort study; Low Birth Weight Infant; Marijuana; Maternal Health; Measures; Medical Marijuana; Methodology; Mothers; Natural experiment; Outcome; Patient Self-Report; Patients; Play; Policies; Policy Maker; Population; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Birth; Prenatal care; Prevalence; Provider; Public Health; Regulation; Research Personnel; Resources; Risk; Role; Sample Size; Sampling; Small for Gestational Age Infant; Socioeconomic Status; Spontaneous abortion; Surveys; Testing; Tetrahydrocannabinol; Time; Tobacco; Tobacco use; Toxicology; Urine; Uterus; Variant; Woman; aged; alcohol and other drug; base; blood pressure elevation; cohort; density; design; drug use in pregnancy; drug use screening; endogenous cannabinoid system; epidemiology study; fetal; fetal marijuana exposure; hospital readmission; illicit drug use; insight; marijuana legalization; marijuana use; marijuana use in pregnancy; marijuana user; maternal hypertension; maternal marijuana use; maternal outcome; maternal risk; neonatal health; neonatal outcome; novel; obstetric outcomes; offspring; perinatal outcomes; pregnancy hypertension; pregnant; prenatal; prenatal exposure; prenatal testing; programs; prospective; public health relevance; racial and ethnic; response; risk minimization; screening; screening program; sociodemographics; stillbirth; substance use; trend; vasoconstriction; young adult

PROJECT SUMMARY/ABSTRACT Prenatal marijuana use is increasingly recognized as an important public health problem that could have a large scale negative impact on maternal, fetal and neonatal health. We propose a retrospective and prospective longitudinal cohort study of over 400,000 pregnancies screened for prenatal marijuana use based on gold standard self-reported and urine toxicology data from 2009 to 2020, leveraging Kaiser Permanente Northern California’s universal prenatal substance use screening program that is part of standard prenatal care. We will assess associations between maternal marijuana use during pregnancy and key maternal, fetal and neonatal outcomes, controlling for potential confounders (e.g., tobacco use, alcohol and other drug exposure, income) and comparing exposure across trimesters. These analyses also take advantage of a unique natural experiment and will examine whether California state marijuana legalization in 2018 and local regulatory practices (e.g., retailer bans, prominent warnings on marijuana use during pregnancy) are associated with variation in marijuana use during pregnancy. With high generalizability and a sample size unmatched by any other study on this topic, results from each aim have direct implications for the care of pregnant women while providing novel insight to drive future epidemiological and clinical trial-based intervention studies. Aims 1 and 2 will provide generalizable and comprehensive data to understand the health impact of prenatal marijuana use on mothers and their babies. Aim 3 will allow us to identify changing trends in prenatal marijuana use following marijuana legalization and will inform clinicians, researchers, and policy makers of the future scope of the problem. Finally, the study cohort will be a valuable resource for future research on the long-term impact of prenatal marijuana use on maternal and children’s well-being.

项目概要/摘要 产前吸食大麻越来越被认为是一个重要的公共卫生问题，可能会造成 我们建议对孕产妇、胎儿和新生儿健康产生大规模的负面影响。 对超过 400,000 名孕妇进行的前瞻性纵向队列研究，根据产前大麻使用情况进行筛查 利用 Kaiser Permanente，根据 2009 年至 2020 年金标准自我报告和尿液毒理学数据 北加州的通用产前物质使用筛查计划是标准产前的一部分 我们将评估母亲在怀孕期间使用大麻与关键母亲和胎儿之间的关联。 和新生儿结局，控制潜在的混杂因素（例如吸烟、饮酒和其他药物） 暴露、收入）以及跨三个月的暴露比较这些分析还利用了 独特的自然实验，将检验加利福尼亚州大麻合法化是否在2018年以及当地 监管措施（例如零售商禁令、怀孕期间吸食大麻的显着警告） 与怀孕期间大麻使用的变化相关，具有较高的普遍性和样本量。 与该主题的任何其他研究都无法比拟，每个目标的结果都对护理有直接影响 孕妇同时提供新颖的见解来推动未来的流行病学和临床试验 目标 1 和 2 将提供普遍且全面的数据来了解健康状况。 产前吸食大麻对母亲及其婴儿的影响将使我们能够确定产前吸食大麻的变化趋势。 大麻合法化后产前吸食大麻，并将告知内部人士、研究人员和政策 最后，研究队列将成为未来的宝贵资源。 研究产前吸食大麻对孕产妇和儿童福祉的长期影响。