humulene and Pre-Eclampsia

Topics: Abnormalities, Drug-Induced; Abortion, Threatened; Amphetamines; Cannabis; Female; Fetus; Genital Diseases, Female; Hallucinogens; Heroin Dependence; Humans; Infant; Menstruation Disturbances; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Puerperal Disorders; Substance-Related Disorders; Vaginitis

Maternal tobacco and cannabis use during pregnancy are associated with adverse perinatal outcomes. We hypothesized that maternal tobacco and cannabis use are associated with placental adaptations, which subsequently lead to adverse perinatal outcomes. In a population-based prospective cohort study of 8008 pregnant women, we assessed maternal tobacco and cannabis use by questionnaires. Placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured in the first and second trimester and at delivery from blood samples. Placental weight and pregnancy complications were obtained from medical records. We observed that tobacco use before and during first-trimester only was not associated with any angiogenic factors. As compared to no tobacco use, continued use during pregnancy was associated with higher PlGF, lower sFlt-1 concentrations, and lower sFlt-1/PlGF ratio in second trimester (all p-values <0.05). Also, compared to no cannabis use, use before and during pregnancy was associated with higher PlGF concentrations and lower sFlt-1/PlGF ratio in first and second trimester (all p-values <0.05). First trimester only cannabis use was associated with higher sFlt-1 concentrations and higher sFlt-1/PlGF ratio at delivery (all p-values <0.05). Compared to non-use, tobacco use before pregnancy was associated with a higher placental weight, whereas continued tobacco use during pregnancy was associated with a lower placental weight. Continued tobacco or cannabis use was related to higher placental weight to birth weight ratio and higher risk of pregnancy complications (all p-values <0.05). These results suggest that maternal tobacco and cannabis use lead to placental vascular maladaptation predisposing to adverse pregnancy outcomes.

Topics: Biomarkers; Cannabis; Female; Humans; Nicotiana; Placenta; Placenta Growth Factor; Placentation; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Prospective Studies; Tobacco Use; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factor Receptor-1

To evaluate associations between marijuana exposure and adverse outcomes excluding women with polysubstance abuse and stratifying for concurrent maternal tobacco use.. We performed a retrospective cohort study evaluating various obstetrical and neonatal outcomes including: preterm delivery, pre-eclampsia, gestational diabetes, cesarean delivery, fetal growth restriction, a composite which included stillbirth or neonatal intensive care unit admission, and perinatal mortality. We stratified study groups according to the maternal tobacco use and performed a logistic regression analysis.. We included 6468 women, 6107 nonusers and 361 marijuana users. After adjustment for maternal age, race, parity, body mass index and no prenatal care, we found higher rates of small for gestational age (aOR 1.30 (95% CI 1.03 to 1.62)) and neonatal intensive care unit admission (aOR 1.54 (1.14 to 2.07)) in women who were not tobacco users. Other obstetrical outcomes including preterm delivery and fetal anomalies were not increased with maternal marijuana use.. Maternal marijuana use does not increase the risk of adverse obstetrical outcomes or fetal anomalies, but does increase the risk for small for gestational age and neonatal intensive care unit admission.

Topics: Adult; Cannabis; Cesarean Section; Diabetes, Gestational; Female; Gestational Age; Humans; Infant; Infant Mortality; Infant, Newborn; Intensive Care Units, Neonatal; Logistic Models; Marijuana Smoking; Maternal Age; Maternal Exposure; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Premature Birth; Retrospective Studies; Stillbirth; Young Adult