humulene and Birth-Weight

To assess the effects of use of cannabis during pregnancy on maternal and fetal outcomes.. 7 electronic databases were searched from inception to 1 April 2014. Studies that investigated the effects of use of cannabis during pregnancy on maternal and fetal outcomes were included.. Case-control studies, cross-sectional and cohort studies were included.. Data synthesis was undertaken via systematic review and meta-analysis of available evidence. All review stages were conducted independently by 2 reviewers.. Maternal, fetal and neonatal outcomes up to 6 weeks postpartum after exposure to cannabis. Meta-analyses were conducted on variables that had 3 or more studies that measured an outcome in a consistent manner. Outcomes for which meta-analyses were conducted included: anaemia, birth weight, low birth weight, neonatal length, placement in the neonatal intensive care unit, gestational age, head circumference and preterm birth.. 24 studies were included in the review. Results of the meta-analysis demonstrated that women who used cannabis during pregnancy had an increase in the odds of anaemia (pooled OR (pOR)=1.36: 95% CI 1.10 to 1.69) compared with women who did not use cannabis during pregnancy. Infants exposed to cannabis in utero had a decrease in birth weight (low birth weight pOR=1.77: 95% CI 1.04 to 3.01; pooled mean difference (pMD) for birth weight=109.42 g: 38.72 to 180.12) compared with infants whose mothers did not use cannabis during pregnancy. Infants exposed to cannabis in utero were also more likely to need placement in the neonatal intensive care unit compared with infants whose mothers did not use cannabis during pregnancy (pOR=2.02: 1.27 to 3.21).. Use of cannabis during pregnancy may increase adverse outcomes for women and their neonates. As use of cannabis gains social acceptance, pregnant women and their medical providers could benefit from health education on potential adverse effects of use of cannabis during pregnancy.

Topics: Anemia; Birth Weight; Cannabis; Child Health; Female; Gestational Age; Humans; Infant, Low Birth Weight; Infant, Newborn; Intensive Care Units, Neonatal; Marijuana Smoking; Pregnancy; Premature Birth; Prenatal Exposure Delayed Effects

The literature is sparse on the adverse effects of moderate alcohol consumption and marijuana use during pregnancy. Recent studies have evaluated the association of these drugs of abuse with pregnancy outcome, each using interview and medical record data of over 12 000 women. Children of marijuana users were more likely to have one or more major malformations, lower birthweight, and shorter gestation than children of nonusers. However, when logistic regression was used to control for other variables, these relationships were not statistically significant. The odds ratio for major malformations does, however, remain suggestive for marijuana. The use of similar logistic regression techniques revealed that the only statistical association between alcohol intake of 14 or more drinks per week was placenta abruptio. With the exception of placenta abruptio, alcohol intake of fewer than 14 drinks weekly was not associated with an increased risk of any adverse outcome. There was no association between alcohol use at any level and the rate of congenital malformations. Recommendations based on these data are presented.

Topics: Abnormalities, Drug-Induced; Abruptio Placentae; Birth Weight; Cannabis; Ethanol; Female; Fetus; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications; Risk

Cannabis is one of the most common non-prescribed psychoactive substances used in pregnancy. The prevalence of gestational cannabis use is increasing.. The aim was to examine the prevalence of gestational cannabis use and associated pregnancy and neonate outcomes.. A retrospective observational study involving pregnant women delivering in 2019 was conducted at a tertiary hospital in Perth, Western Australia. Gestational cannabis and other substance use records were based on maternal self-report. Pregnancy outcomes included neonatal gestational age, birthweight, birth length, head circumference, resuscitation measures, special care nursery admission, 5-min Apgar score and initial neonatal feeding method.. Among 3104 pregnant women (mean age: 31 years), gestational cannabis use was reported by 1.6% (n = 50). Cannabis users were younger, more likely to use other substances and experience mental illness or domestic violence compared with non-users. Neonates born to cannabis users had a lower mean gestational age, birthweight and birth length compared to those born to non-cannabis users. Gestational cannabis use (odds ratio (OR) 3.3, 95% confidence interval (CI) 1.6-6.7) and tobacco smoking (OR 2.2, 95% CI 1.5-3.6) were associated with increased odds of a low-birthweight neonate. Combined cannabis and tobacco use during pregnancy further increased the likelihood of low birthweight (LBW, adjusted OR 3.9, 95% CI 1.6-9.3). Multivariate logistic regression analysis adjusted for maternal sociodemographical characteristics, mental illness, alcohol, tobacco and other substance use demonstrated gestational cannabis use to be independently associated with LBW (OR 2.3, 95% CI 1.1-5.2).. Gestational cannabis use was independently associated with low birthweight, synergistically affected by tobacco smoking.

Topics: Adult; Australia; Birth Weight; Cannabis; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Outcome; Prevalence; Substance-Related Disorders; Tertiary Care Centers

To estimate the independent and combined effects of in utero exposures on birth outcomes in a rural population.. The study used population-level data (2020-2022) from a state-wide surveillance tool (Working in Appalachia to identify at-risk infants, Critical congenital heart disease, and Hearing loss) in West Virginia. Outcomes included low birth weight, preterm birth, small for gestational age, and birth weight in grams. Exposure included a composite variable with 8 levels of 3 exposure (opioids, stimulants, and cannabis) categories. Analyses were adjusted for sociodemographic covariates using multiple logistic and linear regression analyses.. Of the 34 412 singleton live births, 1 in 8 newborns (12.2%) had in utero exposure(s) to opioids, stimulants, and/or cannabis, 11.5% were preterm, 7.9% had low birthweight, 9.6% were small for gestational age, and mean birth weight was 3249 ± 563.6 g. Preterm birth was associated with stimulant alone exposure (aOR, 1.40; 95% CI, 1.03-1.89) and stimulant and cannabis concurrent exposure (aOR, 1.69; 95% CI, 1.16, 2.47). Low birthweight was associated with opioids alone (aOR, 1.34; 95% CI, 1.10, 1.63), cannabis alone (aOR, 1.31; 95% CI, 1.13 to -1.52), opioid and cannabis (aOR, 1.61; 95% CI, 1.12 to -2.31), and opioids, stimulants, and cannabis concurrent exposures (aOR, 2.27; 95% CI, 1.43-3.61). Five exposure categories were associated with lower birth weights (adjusted mean difference range. -72 to -211 g). Small for gestational age was associated with opioids alone (aOR, 1.48; 95% CI, 1.24-1.78), cannabis alone (aOR, 1.49; 95% CI, 1.31-1.69), and opioids and cannabis concurrent exposures (aOR, 1.91; 95% CI, 1.36-2.67).. We showed complex associations between in utero substance exposures, preterm birth, birth weight, and sociodemographic factors in a rural population. The results may inform policy efforts to improve maternal and child health in socioeconomically disadvantaged and underserved rural populations.

Topics: Analgesics, Opioid; Birth Weight; Cannabis; Child; Cohort Studies; Female; Humans; Infant; Infant, Low Birth Weight; Infant, Newborn; Premature Birth

To examine the relationship between reported prenatal cannabis use and neonatal and maternal outcomes and whether the legalisation of cannabis in Canada affected the rates of reported use or the association with maternal and neonatal outcomes.. Population-based retrospective cohort study.. Routinely collected data in a real-world setting.. All women in the Canadian province of Nova Scotia with singleton births between 1 January 2004 and 30 June 2021.. The association between cannabis use and maternal and neonatal outcomes was examined using generalised linear models with inverse probability weighting.. Maternal and neonatal outcomes in the peripartum and postpartum period.. Rates of reported cannabis use in pregnancy increased from 1.3% to 7.5% over the study period with no appreciable change in slope after legalisation in 2018. Infants of mothers reporting cannabis use in pregnancy were more likely to have major anomalies and a 5-minute Apgar score ≤7, require neonatal intensive care unit admission, and had lower birthweight, head circumference and birth length than infants of mothers not reporting cannabis use. These associations did not differ before and after legalisation.. Reported cannabis use during pregnancy is associated with early postnatal complications and reduced fetal growth, even after taking into account a range of confounding factors. Rates of reported cannabis use during pregnancy increased over the past 5 years in Nova Scotia with no apparent additional effect of legalisation.

Topics: Birth Weight; Cannabis; Female; Humans; Infant; Infant, Newborn; Nova Scotia; Pregnancy; Pregnancy Outcome; Retrospective Studies

To assess the impact of fetal exposure to cannabis on adiposity and glucose-insulin traits in early life.. We leveraged a subsample of 103 mother-child pairs from Healthy Start, an ethnically diverse Colorado-based cohort. Twelve cannabinoids/metabolites of cannabis (including Δ9-tetrahydrocannabinol and cannabidiol) were measured in maternal urine collected at ~27 weeks' gestation. Fetal exposure to cannabis was dichotomized as exposed (any cannabinoid > limit of detection [LOD]) and not exposed (all cannabinoids < LOD). Fat mass and fat-free mass were measured via air displacement plethysmography at follow-up (mean age: 4.7 years). Glucose and insulin were obtained after an overnight fast. Generalized linear models estimated the associations between fetal exposure to cannabis with adiposity measures (fat mass [kg], fat-free mass [kg], adiposity [fat mass percentage], body mass index [BMI], and BMI z-scores) and metabolic measures (glucose [mg/dL], insulin [uIU/mL], and homeostatic model assessment of insulin resistance [HOMA-IR]).. Approximately 15% of the women had detectable levels of any cannabinoid, indicating fetal exposure to cannabis. Exposed offspring had higher fat mass (1.0 kg; 95% CI, 0.3-1.7), fat-free mass (1.2 kg; 95% CI, 0.4-2.0), adiposity (2.6%; 95% CI, 0.1-5.2), and fasting glucose (5.6 mg/dL; 95% CI, 0.8-10.3) compared with nonexposed offspring. No associations were found with fasting insulin (in the fully adjusted model), HOMA-IR, BMI, or BMI z-scores.. We provide novel evidence to suggest an association between fetal exposure to cannabis with increased adiposity and fasting glucose in childhood, a finding that should be validated in other cohorts.

Topics: Adiposity; Birth Weight; Blood Glucose; Body Mass Index; Cannabinoids; Cannabis; Child, Preschool; Female; Glucose; Humans; Insulin; Obesity

Previous literature on the effects of marijuana exposure on neonatal outcomes has been limited by the reliance on maternal self-report. The objective of this study was to examine the relationship of prenatal marijuana exposure on neonatal outcomes in infants with marijuana exposure confirmed with meconium drug testing.. Retrospective cohort study.. Meconium drug screens obtained on infants born in a hospital system in the Pacific Northwest in the USA over a 2.5-year period. 1804 meconium drug screens were initially obtained, with 1540 drug screens included in the analysis.. Neonates with meconium drug screens positive for delta-9-tetrahydrocannabinol (THC) only were compared with neonates with negative drug screens. The following neonatal outcomes were examined: gestational age, preterm birth (<37 weeks), birth weight, low birth weight (defined as birth weight <2.5 kg), length, head circumference, Apgar scores and admission to the neonatal intensive care unit (NICU). Using multivariable logistical and linear regression, we controlled for confounding variables.. 1540 meconium drug screens were included in the analysis, with 483 positive for delta-9-THC only. Neonates exposed to delta-9-THC had significantly lower birth weight, head circumference and length (p<0.001). Neonates with THC exposure had 1.9 times the odds (95% CI 1.3 to 2.7, p=0.001) of being defined as low birth weight. Birth weight was on average 0.16 kg lower (95% CI 0.10 to 0.22, p<0.001) in those exposed to THC.. Prenatal marijuana exposure was significantly associated with decreases in birth weight, length and head circumference, and an increased risk of being defined as low birth weight. These findings add to the previous literature demonstrating possible negative effects of prenatal marijuana use on neonatal outcomes.

Topics: Birth Weight; Cannabis; Dronabinol; Female; Humans; Infant; Infant, Newborn; Pregnancy; Premature Birth; Retrospective Studies

This study aimed to characterize the relationship between cannabis use, ACE score, and pregnancy outcomes. Pregnant patients in Baltimore, MD, completed the 17-point ACE checklist. Charts of the birth parent and neonate were reviewed for urine toxicology testing at initiation of care and delivery, prenatal care metrics, and birth statistics. Multivariable logistic regression analysis was performed to assess the relationship between ACE score, cannabis use, and pregnancy outcomes. Of 256 birth parents, 87 (34.0%) tested positive for cannabis at initial visit and 39 (15.2%) tested positive for cannabis at delivery. Testing positive for cannabis at initial visit or delivery was associated with higher ACE score (15.1 vs 13.7, p = 0.04; 16.2 vs 13.8, p = 0.01). Of those who tested positive for cannabis at initial visit, 39/87 (45.0%) tested positive at delivery. Continued cannabis use at delivery was associated with lower maternal weight gain (7.9 kg vs 13.3 kg, p = 0.003), fewer prenatal visits (7 vs 8, p = 0.010), and numerically higher mean ACE score. Cannabis use at delivery was associated with 10% lower birthweight (2665 g vs 3014 g p < 0.05) but not with pre-term birth. Total ACE score was not significantly associated with any birth outcome. Worse pregnancy outcomes were associated with cannabis use throughout pregnancy but not with cannabis use at prenatal care initiation. The interplay of ACE and continued cannabis use during pregnancy warrants further research on the physiologic effects of cannabis and interventions to decrease substance use during pregnancy.

Topics: Adverse Childhood Experiences; Birth Weight; Cannabis; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Outcome; Prenatal Care

As U.S. states legalize recreational cannabis, some enact policies requiring Mandatory Warning Signs for cannabis during pregnancy (MWS-cannabis). While previous research has found MWS for alcohol during pregnancy (MWS-alcohol) associated with increases in adverse birth outcomes, research has not examined effects of MWS-cannabis. This study uses Vital Statistics birth certificate data from June 2015 - June 2017 in seven western states and policy data from NIAAA's Alcohol Policy Information System and takes advantage of the quasi-experiment created by Washington State's enactment of MWS-cannabis in June 2016, while nearby states did not. Outcomes are birthweight, low birthweight, gestation, and preterm birth. Analyses use a Difference-in-Difference approach and compare changes in outcomes in Washington to nearby states in the process of legalizing recreational cannabis (Alaska, California, Nevada) and, as a secondary analysis, nearby states continuing to criminalize recreational cannabis (Idaho, Montana, Wyoming). Birthweight was -7.03 g lower (95% CI -10.06, -4.00) and low birthweight 0.3% higher (95% CI 0.0, 0.6) when pregnant people were exposed to MWS-cannabis than when pregnant people were not exposed to MWS-cannabis, both statistically significant (p = 0.005 and p = 0.041). Patterns for gestation, -0.014 weeks earlier (95% CI -0.038, 0.010) and preterm birth 0.2% higher (95% CI -0.2, 0.7), were similar, although not statistically significant (p = 0.168 and 0.202). The direction of findings was similar in secondary analyses, although statistical significance varied. Similar to MWS-alcohol, enacting MWS-cannabis is associated with an increase in adverse birth outcomes. The idea that MWS-cannabis provide a public health benefit is not evidence-based.

Topics: Birth Weight; Cannabis; Ethanol; Female; Humans; Infant, Newborn; Policy; Pregnancy; Pregnancy Outcome; Premature Birth; United States; Washington

This study aimed to study the relationship between prenatal marijuana and infant birth weight using natural cohorts established before, during and after the 20-month lapse between legalization and legal recreational sales in Washington State.. Over 5 years, 5,343 pregnant women with documented urine drug screen (UDS) results delivered at Tacoma General Hospital or Good Samaritan Hospital. Maternal medical data were extracted for three delivery cohorts established based on before (T1), during (T2), and after legalization (T3) of recreational marijuana and legalized availability. Univariate and multivariate models were created to study marijuana exposure on infants' birth weight.. Marijuana exposure increased the risk of low birth weight (LBW; odds ratio [OR] = 1.42, 95% confidence interval [CI]: 1.01-2.01). This was more pronounced in full-term babies (OR = 1.72, 95% CI: 1.10-2.69), and was independently associated with a higher risk for small for gestational age (SGA; OR = 1.51, 95% CI: 1.49-1.53). The associations between marijuana exposure and SGA were maintained in cohort-specific models (OR = 1.53, 95% CI: 1.01-2.32 for T2, and OR = 1.43, 95% CI: 1.01-2.02 for T3, respectively).. Marijuana exposure verified by UDS was associated with LBW and SGA. However, recreational marijuana legalization and availability did not have direct impact on newborns' risk of LBW or SGA.

Topics: Adult; Analysis of Variance; Birth Weight; Body Mass Index; Cannabis; Female; Fetus; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Small for Gestational Age; Male; Maternal Age; Maternal Exposure; Odds Ratio; Pregnancy; Recreational Drug Use; Washington

Marijuana is the most commonly used illicit drug in pregnancy, and the prevalence of use during pregnancy is increasing in the United States. Although much of the existing research investigating marijuana use in pregnancy is limited by study design and confounding factors, a growing accumulation of data suggests adverse outcomes. Studies have identified associations with decreased birth weight, increased spontaneous preterm birth, and impaired neurodevelopment among children and adults with in utero exposure. Moderate concentrations of marijuana have also been identified in breast milk. Due to these findings, multiple professional societies have issued clear statements against marijuana use during pregnancy and lactation.

Topics: Adult; Birth Weight; Breast Feeding; Cannabis; Child; Female; Fetus; Humans; Infant, Low Birth Weight; Infant, Newborn; Lactation; Marijuana Smoking; Marijuana Use; Maternal Exposure; Milk, Human; Neurodevelopmental Disorders; Pregnancy; Pregnancy Complications; Pregnant Women; Premature Birth; Prenatal Exposure Delayed Effects; United States

To determine whether maternal and infant outcomes are associated with exposure to marijuana during the third trimester in a population of opioid dependent pregnant women maintained on buprenorphine.. This retrospective cohort study of 191 maternal-infant dyads exposed to buprenorphine during pregnancy examines a variety of variables including gestational age, birthweight, method of delivery, Apgar scores at one and five minutes, duration of infant hospital stay, peak neonatal abstinence syndrome (NAS) score, duration of NAS and incidence of pharmacologic treatment of NAS in infants exposed to marijuana during the third trimester as compared to infants not exposed to marijuana during the third trimester.. Analyses failed to support any significant relationship between marijuana use in the third trimester and a variety of maternal and infant outcomes. Two important variables - the likelihood of requiring pharmacologic treatment for NAS (27.6% in marijuana exposed infants vs. 15.7% in non-marijuana exposed infants, p=0.066) and the duration of infant hospital stay (7.7days in marijuana exposed infants vs. 6.6days in non-exposed infants, p=0.053) trended toward significance.. Preliminary results indicate that marijuana exposure in the third trimester does not complicate the pregnancy or the delivery process. However, the severity of the infant withdrawal syndrome in the immediate postnatal period may be impacted by marijuana exposure. Because previous study of prenatal marijuana exposure has yielded mixed results, further analysis is needed to determine whether these findings are indeed significant.

Topics: Analgesics, Opioid; Birth Weight; Buprenorphine; Cannabis; Female; Gestational Age; Humans; Infant; Infant, Newborn; Length of Stay; Marijuana Smoking; Neonatal Abstinence Syndrome; Opioid-Related Disorders; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Third; Retrospective Studies; Substance Withdrawal Syndrome

This study examines the prevalence, behaviors, and birth outcomes associated with marijuana use in pregnancy. This was a retrospective cohort from a university-based prenatal care clinic from July 1, 2009 to June 30, 2010. The primary exposure was marijuana use, defined by self-report or urine toxicology. Demographic and outcome data were determined by chart review and analyzed by chi-square test, Fisher's exact test, ANOVA, and logistic regression. Three hundred and ninety-six patients initiated prenatal care during this time frame; 116 (29.3 %) of whom screened positive for marijuana at initial visit. Patients who used marijuana were less likely to have graduated high school (p = 0.016) or be employed (p = 0.015); they were more likely to use tobacco (p < 0.001) or alcohol (p = 0.032) and report a history of abuse (p = 0.010) or depressed mood (p = 0.023). When analyzed via logistic regression, only tobacco use remained associated with marijuana use (adjusted odds ratio (OR) = 3.3; 95 % confidence interval (CI): 1.9-5.9). Birth outcomes were available for 170 (43.0 %) patients. Only 3 (1.9 %) tested positive for marijuana at the time of delivery. Marijuana use was not related to incidence of low birth weight (13.8 % vs 14.0 %, p = 1.00), preterm delivery (17.7 % vs 12.0 %, p = 0.325), or NICU admissions (25.5 % vs 15.8 %, p = 0.139). Prenatal care utilization was equal between marijuana users and non-users. Although marijuana is common among obstetric patients at prenatal care initiation, most cease use by delivery. Marijuana is strongly correlated with cigarette use. We found no differences in birth outcomes or utilization of prenatal care by marijuana exposure.

Topics: Adult; Birth Weight; Cannabis; Female; Health Services Accessibility; Humans; Logistic Models; Male; Marijuana Abuse; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Prenatal Care; Prevalence; Retrospective Studies; Young Adult

Pigs may display biting behavior directed at pen mates, resulting in body damage such as tail wounds. We assessed the suitability of jute sacks (hung vertically at wall) to reduce biting behaviors and tail wounds in rearing gilts. Additionally, we assessed several characteristics of different types of tail biters. Tail docked rearing gilts originated from 72 litters, which were kept in partly slatted pens with jute sacks (J) or barren control pens (CON; 36 litters per treatment). Tail and ear damage were observed at weaning (4 wk) and during the weaner and rearing phase (17 J and 19 CON pens). Sow (dam) damage was also considered. Biting behaviors (tail, ear, and other) were observed during the weaner and rearing phase. Weight was recorded at birth, weaning, and end of the weaner phase and ADG was calculated from birth till weaning and from weaning till 9 wk. Furthermore, estimated breeding values for litter size, litter birth weight, back fat, and growth between birth and ∼ 105 kg, and ∼ 25 to 105 kg were determined. Jute sacks reduced tail and ear damage at weaning (both P < 0.001) and tended to reduce sow tail damage (P = 0.09). Jute sacks also reduced tail damage post-weaning (P < 0.001 to 0.03), with a 5-fold reduction of (mild) tail wounds at the age of 13 wk. Biting behaviors directed at pen mates were up to 50% lower in J pens (P < 0.001 to 0.04). Higher genotypic litter size, litter birth weight, growth, and lower back fat seemed associated with higher levels of ear or tail-biting behavior (P = 0.002 to 0.09), albeit dependent on treatment and phase. Higher phenotypic litter sizes were associated with higher levels of biting behaviors (P = 0.004-0.08). High-tail-biters and Medium-tail-biters (the latter less pronounced) stemmed from larger litters (P = 0.01 to 0.05), were heavier (P = 0.03 to 0.04), grew faster (P = 0.05 to 0.08), and displayed higher levels of all kinds of biting behavior directed to pen mates and the jute sack (P < 0.001 to 0.10) compared with non-tail-biters, the effect size dependent on treatment and phase of life. To conclude, jute sacks may profoundly reduce damaging behaviors and tail wounds in rearing gilts, probably because they partly meet the behavioral need of pigs for rooting and chewing. Furthermore, (tail) biting is associated with production level of the gilts (phenotypically and genetically), which suggests a role for breeding programs and additional research focusing on metabolic demands of (tail) biting pigs.

Topics: Animal Husbandry; Animal Welfare; Animals; Behavior, Animal; Birth Weight; Bites and Stings; Body Weight; Breeding; Cannabis; Female; Housing, Animal; Litter Size; Swine; Weaning

The objectives of this study were 1) to assess whether there is an independent association between the level of prenatal cocaine exposure and infants' developmental test scores after control of potential confounding variables; and 2) if such an association exists, to determine which biological and social variables, individually and in interaction with each other, may modify it.. In a prospective, longitudinal study of 203 urban term infants, 3 cocaine exposure groups were defined by maternal report and infant meconium assay: unexposed, heavier cocaine exposure (>75th percentile self-reported days of use or meconium benzoylecognine concentration), or lighter cocaine exposure (all others). Examiners, masked to exposure history, tested infants at 6, 12, and 24 months of age with the Bayley Scales of Infant Development.. The final mixed linear regression model included as fixed covariates level of prenatal exposure to cocaine, alcohol, and cigarettes; prenatal marijuana exposure; gestational age and birth weight z score for gestational age; and gender. Age at test, caregiver at time of each test (biological mother, kinship caregiver, unrelated foster caregiver), and any previous child-focused early intervention were included as time-dependent covariates. There were no significant adverse main effects of level of cocaine exposure on Mental Development Index (MDI), Psychomotor Development Index (PDI), or Infant Behavior Record. Child-focused early intervention interacted with level of cocaine exposure such that heavily exposed children who received such intervention showed higher adjusted mean MDI scores than all other groups. Although the sample was born at or near term, there was also a significant interaction of cocaine exposure and gestational age on MDI scores, with those in the heavier exposure group born at slightly lower gestational age having higher mean MDI scores compared with other children born at that gestational age. There was also a significant interaction on MDI between child's age and caregiver. At 6 months, the adjusted MDI of children living with a kinship caregiver was 15.5 points lower than that of children living with their biological mother, but this effect was diminished and was no longer significant at 24 months (difference in means: 4.3 points). The adjusted mean MDI of children in unrelated foster care at 6 months was 8.2 points lower than children of biological mothers, whereas it was 7.3 points higher at 24 months. Early intervention attenuated the age-related decline in PDI scores for all groups. Birth weight <10th percentile was associated with lower PDI scores for children with heavier cocaine exposure and with lower MDI scores for all groups.. Heavier prenatal cocaine exposure is not an independent risk factor for depressed scores on the Bayley Scales of Infant Development up to 24 months of age when term infants are compared with lighter exposed or unexposed infants of the same demographic background. Cocaine-exposed infants with birth weight below the 10th percentile for gestational age and gender and those placed with kinship caregivers are at increased risk for less optimal developmental outcomes. Pediatric clinicians should refer cocaine-exposed children to the child-focused developmental interventions available for all children at developmental risk.

Topics: Birth Weight; Boston; Cannabis; Caregivers; Child Development; Cocaine; Confounding Factors, Epidemiologic; Female; Humans; Infant, Newborn; Linear Models; Longitudinal Studies; Meconium; Models, Statistical; Multivariate Analysis; Pregnancy; Prenatal Exposure Delayed Effects; Prospective Studies; Psychomotor Performance; Risk Factors; Surveys and Questionnaires; Tobacco Smoke Pollution

To determine the mortality rate, during the first 2 years of life, in infants who were exposed to cocaine, opiate, or cannabinoid during gestation.. For a period of 11 months, a large group of infants were enrolled and screened at birth for exposure to cocaine, opiate, or cannabinoid by meconium analysis. Death outcome, within the first 2 years after birth, was determined in this group of infants using the death registry of the Michigan Department of Public Health.. A total of 2964 infants was studied. At birth, 44% of the infants tested positive for drugs: 30. 5% positive for cocaine, 20.2% for opiate, and 11.4% for cannabinoids. Compared to the drug negative group, a significantly higher percentage (P < .05) of the drug positive infants had lower weight and smaller head circumference and length at birth and a higher percent of their mothers were single, multigravid, multiparous, and had little to no prenatal care. Within the first 2 years of life, 44 infants died: 26 were drug negative (15.7 deaths per 1000 live births) and 18 were drug positive (13.7 deaths per 1000 live births). The mortality rate among cocaine, opiate, or cannabinoid positive infants were 17.7, 18.4, and 8.9 per 1000 live births, respectively. Among infants with birth weight

Topics: Birth Weight; Cannabinoids; Cannabis; Cocaine; Confidence Intervals; Data Interpretation, Statistical; Female; Humans; Infant; Infant Mortality; Infant, Newborn; Male; Meconium; Narcotics; Neonatal Screening; Odds Ratio; Opioid-Related Disorders; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Registries; Sudden Infant Death

Findings reported are for a subset of African American subjects, residing in the urban area of Washington, D. C., who participated in a Program Project designed to study nutrition, other factors, and the outcome of pregnancy. Fasting blood samples, drawn during each trimester of pregnancy and at delivery, were screened for concentrations of cocaine, phencyclidine (PCP) and marijuana. Since substance abusers are expected to consume inadequate diets, these samples were also analyzed for serum folate, vitamin B12, ferritin and ascorbic acid. Data for these biochemical variables were compared for subjects whose serum values for drugs were either above or below the drug screening threshold concentrations established by ADAMHA/NIDA. Pearson's correlations were used to determine relationships between pregnancy outcome variables and maternal serum drug concentrations. Blood samples drawn at delivery showed higher maternal: cord ratios (mean +/- SEM) for marijuana (3.3 +/- 2.2) and PCP (2.9 +/- 1.0) than for cocaine (1.0 +/- 0.2). The subjects whose serum values were above the ADAMHA/NIDA ranges for marijuana, PCP and cocaine had concentrations of folate and ferritin that were significantly less than those of subjects with lower serum drug levels (P < or = 0.05). High maternal serum concentrations of illicit drugs were accompanied by a significant increase in leukocyte count (P < or = 0.05). The level of maternal cocaine during the third trimester was inversely correlated with birthweight (r = -0.29; n = 52; P = 0.038) and head circumference (r = -0.28; n = 52; P = 0.047).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Ascorbic Acid; Birth Weight; Black or African American; Cannabis; Cocaine; District of Columbia; Female; Ferritins; Fetal Blood; Folic Acid; Gestational Age; Humans; Infant, Newborn; Labor, Obstetric; Nutritional Status; Phencyclidine; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Substance-Related Disorders; Vitamin B 12

The relations of cigarette smoking, alcohol drinking and marijuana use during pregnancy to birthweight were examined in two prospectively studied pregnancy cohorts (Phases I and II). After analytic adjustment in ordinary least squares regressions for other factors that influence birthweight, cigarette smoking during at least half the pregnancy was associated with a significant decrease in mean birthweight (159 grams in Phase I, 202 grams in Phase II). In Phase II only, beer drinking was associated with a significant decrement of 8.4 grams in estimated birthweight per ounce of absolute alcohol per month. Neither wine nor liquor drinking in the Phase II data nor any of the three beverages in the Phase I data was associated with significant decrements in predicted birthweight. Furthermore, with one exception (drinking once a week in Phase II only), alcohol drinking, defined as the number of occasions per month on which any alcoholic beverage was consumed, was not associated with a change in birthweight. Regarding marijuana use, the data are not consistent between the two phases. In the Phase I data, no coherent trend in association with birthweight was observed. In the Phase II data, marijuana use 2-3 times per week, 4-6 times per week and daily was associated with increasing decrements in estimated birthweight: 127 g, 143 g and 230 g respectively. The inconsistent findings for alcohol drinking and marijuana use between phases stand in marked contrast to the consistent findings for cigarette smoking.

Topics: Adult; Alcohol Drinking; Birth Weight; Cannabis; Female; Humans; Infant, Newborn; Pregnancy; Prospective Studies; Smoking

In a prospective study of 3,857 pregnancies ending in singleton live births at Yale-New Haven Hospital, New Haven, Connecticut, in 1980-1982, 9.5% of mothers reported using marijuana (4.1% occasionally and 5.4% at least 2-3 times monthly). Among white women, regular use was associated with an increased risk of delivering a low birth weight (less than 2,500 gm) infant (odds ratio (OR) = 2.6, 95% confidence interval (CI) = 1.1-6.2) and small for gestational age infant (OR = 2.3, 95% CI = 1.3-4.1) after adjustment for other risk factors. Nonwhite marijuana users were not at further increased risk for delivering a low birth weight or small gestational age infant beyond the elevated rates of these conditions already experienced by nonwhites in general. Marijuana use was also related to preterm delivery (gestational age less than 37 weeks from last menstrual period) in white women (OR = 1.9, 95% CI = 1.0-3.9) but not nonwhite women. Occasional use was unrelated to the risk of low birth weight, small for gestational age, or preterm delivery.

Topics: Adult; Birth Weight; Cannabis; Female; Fetal Growth Retardation; Gestational Age; Humans; Infant, Low Birth Weight; Infant, Newborn; Pregnancy; Racial Groups

Results from a previous epidemiologic study indicate that marijuana use near term may elevate risk of abnormal progress of labor and meconium staining. We conducted a study of the association of self-reported marijuana use and perinatal problems in a series of 313 women enrolled in a home-birth center. The 41 marijuana users were similar to non-users with respect to most potentially confounding factors, but users had lower mean income and exhibited more tobacco and alcohol use during pregnancy than non-users. Users experienced slightly elevated rates of dysfunctional labor (43% vs. 35% in non-users), precipitate labor (13% vs. 8%) and meconium staining (17% vs. 13%); differences with respect to most other outcomes were smaller or nonexistent. The observed differences were smaller in both relative and absolute terms than those reported by the earlier study, and were little changed upon adjustment for potentially confounding factors (including alcohol use, cigarette use, parity and income). After accounting for statistical variation, the results appear consistent with the earlier findings but further research is recommended.

Topics: Adult; Birth Weight; Cannabis; Female; Home Childbirth; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Obstetric Labor Complications; Pregnancy; Regression Analysis

Pregnant rats were intubated with marihuana extract (10, 150 mg/kg) from gestation day 3 to parturition. Control animals were pair-fed. At parturition pups were culled and assigned to nondrug-treated dams. A positive control group consisting of animals prenatally exposed to alcohol (6 g/kg/day) was included for comparison of birth weight data. Marihuana reduced food and water consumption and maternal weight gain. Pup weight at birth was reduced by about 10% relative to pair-fed controls in animals exposed to the high doses of marihuana, and by approximately 15% in pups exposed to alcohol relative to their pair-fed controls. Litter size and pup mortality at birth were not affected significantly. Postnatal mortality was increased and neonatal weight was decreased at 21 days in marihuana-treated offspring. At 11 weeks of age body weights of drug-treated females but not males, were still significantly less than that of pair-fed controls.

Topics: Animals; Birth Weight; Body Weight; Cannabis; Drinking; Eating; Ethanol; Female; Fertility; Growth; Pregnancy; Pregnancy, Animal; Rats

Topics: Abnormalities, Drug-Induced; Adrenal Glands; Animals; Birth Weight; Body Weight; Cannabis; Chromatography, Gas; Dronabinol; Female; Fetus; Heart; Lactation; Liver; Organ Size; Pregnancy; Pregnancy, Animal; Rats; Rats, Inbred Strains; Thyroid Gland; Time Factors