title: Maternal marijuana use and neonatal morbidity.
abstract: OBJECTIVE
  Marijuana use is becoming increasingly common in the obstetric population; however, it is unknown whether it is associated with poor neonatal outcomes. We sought to determine the prevalence and risk factors for marijuana use in pregnancy and to evaluate whether marijuana use is independently associated with poor neonatal outcomes.
  
  
  METHODS
  This was a retrospective cohort study of all consecutive, nonanomalous, term deliveries at 1 institution over a 4-year study period. Women with marijuana use during pregnancy, either by self-report or positive urine drug screen, were compared with women who did not use marijuana. The primary outcome was a composite neonatal morbidity including birthweight less than 2500 g, neonatal intensive care unit admission, 5-minute Apgar score less than 7, and umbilical artery pH less than 7.10. Univariate, bivariate, and multiple logistic regression analyses were performed.
  
  
  RESULTS
  Among the 8138 women in the cohort, 680 (8.4%) used marijuana during pregnancy. Women who used marijuana were younger; more likely to be of African American race; have inadequate prenatal care; and use tobacco, alcohol, and other drugs. Medical comorbidities did not differ between groups. After adjusting for smoking, other drug use, and African American race, the composite and all individual markers of poor neonatal outcome were not significantly higher among women who used marijuana during pregnancy.
  
  
  CONCLUSIONS
  Marijuana use is common in pregnancy but may not be an independent risk factor for poor neonatal outcomes in term pregnancies.
authors.affiliation: Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, St. Louis, MO. Electronic address: conners@wudosis.wustl.edu.
authors.forename: Shayna N
authors.initials: SN
authors.lastname: Conner
authors.affiliation: Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, St. Louis, MO.
authors.forename: Ebony B
authors.initials: EB
authors.lastname: Carter
authors.affiliation: Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, St. Louis, MO.
authors.forename: Methodius G
authors.initials: MG
authors.lastname: Tuuli
authors.affiliation: Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, St. Louis, MO.
authors.forename: George A
authors.initials: GA
authors.lastname: Macones
authors.affiliation: Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, St. Louis, MO.
authors.forename: Alison G
authors.initials: AG
authors.lastname: Cahill
mesh_terms: D000328:Adult; D001034:Apgar Score; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D008385:Marijuana Smoking / Q000009:adverse effects* / Q000453:epidemiology; D008425:Maternal Behavior; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
keywords: cannabis; marijuana; morbidity; neonatal; pregnancy