PC1125: Association Between Prenatal Cannabis Use and the Neonatal Outcomes in Newborns Delivered at Brookdale University Hospital, a Retrospective Cohort Study

Background: Cannabis, also known as marijuana, is considered the most used recreational drug in pregnancy. The study of maternal and fetal consequences of prenatal cannabis use has yielded conflicting results. As a result, it is currently unknown how significantly cannabis may impact fetal growth and development, potentially leading to physical and psychopathological consequences during the postnatal, childhood and adolescence periods.

OBJECTIVE
To assess maternal characteristics for cannabinoid use during pregnancy and the effects of prenatal cannabinoids exposure on neonatal outcomes.

Methods: This is a retrospective cohort study that included pregnant women admitted to OBH at Brookdale Hospital for delivery between May 2016 and 2021 who had a Drug of Abuse screen in Urine-8 (DAU-8) done within 48 hours before delivery.

Predictor variables included maternal demographics, age, ethnicity, marital status, parity, employment status, and maternal health behaviors during pregnancy, tobacco use, and other substance abuse during pregnancy. Outcome variables were neonatal gestational age, birth weight, head circumference, Apgar score at 5 minutes, need for neonatal intensive care unit (NICU) level II or higher admission, development of respiratory distress requiring FiO2 > 21%, development of anemia and length of hospital stay.

Percentage and mean (±standard deviation) or median (interquartile ratio) were used for descriptive statistics of nominal data (according to normal distribution). A logistic regression model was performed to all studied risk factors and the adjusted OR (95% CI) was obtained. Cannabinoid exposed and non-exposed were matched within strata representing unique combinations of covariate categories. Any stratum with no reported cannabis exposure were excluded. All available controls were selected for matching gestational age and weights so that the covariate distribution for non-exposed is normalized to match the distribution in the exposed

Results: Of 1684 pregnancies and live birth deliveries, 266 (15.8%) were exposed to cannabinoids and met inclusion criteria. Table 1 summarizes patient characteristics: median maternal age was 26.5 years (IQR= 23-32), 13% were employed and 50% self-reported smoking during pregnancy. Median gestational age was 38.5 weeks (IQR =36.5-39.5).
Cannabis use in pregnancy was associated with lower birth weight (p < 0.001; OR = 0.999 ; 95% CI 0.999-0.999), microcephaly (OR =1.398; 95% CI 1.002-1.951), and higher NICU admissions (OR = 1.380; 95% CI 1.022-1.864). Table 2 shows the logistic regression model for the effect of cannabis on neonatal outcomes that were significant in univariate analysis. No significant differences were found in the outcomes of birth gestational age (p 0.106, OR=1.077; 95% CI 0.985-1.177), length at birth (p 0.495; OR 1.005; 95% CI 0.991-1.018) or the length of NICU of stay in days (p 0.093, OR=0.990; 95%CI 0.978-1.002).

Conclusion: Cannabis use during pregnancy is associated with increased risk of adverse birth outcomes, including lower birth weight, microcephaly and higher rate of admission to the NICU.