title: Association between marijuana use and adverse obstetrical and neonatal outcomes.
abstract: OBJECTIVE
  To evaluate associations between marijuana exposure and adverse outcomes excluding women with polysubstance abuse and stratifying for concurrent maternal tobacco use.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: C R
authors.initials: CR
authors.lastname: Warshak
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: J
authors.initials: J
authors.lastname: Regan
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: B
authors.initials: B
authors.lastname: Moore
authors.affiliation: Department of Obstetrics and Gynecology, The Christ Hospital, Cincinnati, OH, USA.
authors.forename: K
authors.initials: K
authors.lastname: Magner
authors.affiliation: Department of Obstetrics and Gynecology, Northwestern University of Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: S
authors.initials: S
authors.lastname: Kritzer
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: J
authors.initials: J
authors.lastname: Van Hook
mesh_terms: D000328:Adult; D002188:Cannabis / Q000009:adverse effects; D002585:Cesarean Section; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D016015:Logistic Models; D008385:Marijuana Smoking / Q000009:adverse effects*; D008423:Maternal Age; D018811:Maternal Exposure / Q000009:adverse effects*; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology*; D012189:Retrospective Studies; D050497:Stillbirth; D055815:Young Adult