孕妇产前大麻使用和主要结构性出生缺陷

IF 1.6 4区医学 Q4 DEVELOPMENTAL BIOLOGY

Birth Defects Research Pub Date : 2025-06-06 DOI:10.1002/bdr2.2492

Lyndsay A. Avalos, Sara R. Adams, Stacey E. Alexeeff, Nina R. Oberman, Monique B. Does, Kristin R. Steuerle, Deborah R. Ansley, Carley L. Castellanos, Alisa A. Padon, Lynn D. Silver, Kelly C. Young-Wolff

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引用次数: 0

摘要

目的评估产前大麻使用与儿童主要结构性出生缺陷之间的关系。方法：以人群为基础的回顾性队列研究纳入了2011年1月至2020年7月的单胎新生儿，在产前护理开始时普遍筛查药物使用情况。产前使用大麻被定义为在怀孕期间自我报告使用大麻或毒理学测试呈阳性。使用电子健康记录和出生证明数据来确定8个器官系统（即中枢神经、眼睛、耳朵、心脏、口面/呼吸、胃肠道、泌尿生殖系统/肾脏和肌肉骨骼）中的38个特定的主要结构性出生缺陷。采用修正泊松回归模型对倾向得分进行调整。结果在363952例新生儿中，22494例（6.2%）暴露于母体产前使用大麻，6094例（2.17%）存在重大结构性出生缺陷。未调整的孕妇产前大麻使用与胃裂相关（RR = 2.00, 95% CI: 1.25-3.19），其他非大麻产前物质使用与胃裂相关(aRR = 1.68；95% CI: 1.04-2.71)调整后的模型，但对母亲年龄或倾向评分调整后的模型无效。在未调整的模型中，孕妇产前使用大麻与脐膨出相关(RR = 3.04；95% CI: 1.42-6.48)，母亲年龄调整模型(aRR = 3.54；95% CI: 1.68-7.48)，其他产前物质使用调整模型(aRR = 3.31；95% CI: 1.50-7.31)和倾向评分调整模型（aRR: 2.92, 95% CI: 1.26-6.77）。胃裂和脐膨出少见，分别为172例（0.05%）和48例（0.01%）。孕妇产前使用大麻与任何其他出生缺陷之间没有关联。当仅通过毒理学测试来定义大麻时，研究结果得到了重复。结论孕妇产前使用大麻与胃裂和脐膨出的风险增加有关。临床医生应以支持的方式向孕妇提供有关产前使用大麻的潜在危害的咨询。

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Maternal Prenatal Cannabis Use and Major Structural Birth Defects

Objective

We evaluated associations between prenatal cannabis use and major structural birth defects of the child.

Methods

This population-based retrospective cohort study comprised singleton births (January 2011–July 2020) universally screened for substance use at entrance to prenatal care. Prenatal cannabis use was defined as self-reported use or a positive toxicology test during pregnancy. Electronic health record and birth certificate data were used to identify 38 specific major structural birth defects within 8 organ systems (i.e., central nervous, eye, ear, cardiac, orofacial/respiratory, gastrointestinal, genitourinary/renal, and musculoskeletal). Modified Poisson regression models were conducted adjusting for propensity scores.

Results

Of 363,952 infants, 22,494(6.2%) were exposed to maternal prenatal cannabis use, and 6094 infants (2.17%) had a major structural birth defect. Maternal prenatal cannabis use was associated with gastroschisis in the unadjusted (RR = 2.00, 95% CI: 1.25–3.19) and other non-cannabis prenatal substance use (aRR = 1.68; 95% CI: 1.04–2.71) adjusted models, but not in the models adjusted for maternal age or the propensity score. Maternal prenatal cannabis use was associated with omphalocele in the unadjusted model (RR = 3.04; 95% CI: 1.42–6.48), maternal age-adjusted model (aRR = 3.54; 95% CI: 1.68–7.48), other prenatal substance use-adjusted model (aRR = 3.31; 95% CI: 1.50–7.31), and propensity score adjusted model (aRR: 2.92, 95% CI: 1.26–6.77). Cases of gastroschisis and omphalocele were rare: n = 172 (0.05%) and n = 48 (0.01%), respectively. No associations emerged between maternal prenatal cannabis use and any other birth defects. Findings were replicated when cannabis was defined by toxicology testing only.

Conclusions

Maternal prenatal cannabis use was associated with an increased risk for gastroschisis and omphalocele. Clinicians should provide counseling in a supportive manner to pregnant individuals about the potential harms associated with prenatal cannabis use.

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.