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Public health
Research
Prenatal exposure to cannabis and maternal and child health outcomes: a systematic review and meta-analysis
  1. J K L Gunn1,
  2. C B Rosales2,
  3. K E Center3,
  4. A Nuñez4,
  5. S J Gibson5,
  6. C Christ6,
  7. J E Ehiri5
  1. 1Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
  2. 2Mel and Enid Zuckerman College of Public Health, University of Arizona, Phoenix, Arizona, USA
  3. 3Department of Obstetrics and Gynecology, University of Arizona, Tucson, Arizona, USA
  4. 4Arizona Health Sciences Library, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
  5. 5Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
  6. 6Arizona Department of Health Services, Phoenix, Arizona, USA
  1. Correspondence to Professor John Ehiri; jehiri{at}email.arizona.edu

Abstract

Objective To assess the effects of use of cannabis during pregnancy on maternal and fetal outcomes.

Data sources 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.

Study selection Case–control studies, cross-sectional and cohort studies were included.

Data extraction and synthesis Data synthesis was undertaken via systematic review and meta-analysis of available evidence. All review stages were conducted independently by 2 reviewers.

Main outcomes and measures 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.

Results 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).

Conclusions and relevance 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.

  • PUBLIC HEALTH
  • PREVENTIVE MEDICINE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2015-009986

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