title: Risk of neonatal and childhood morbidity among preterm infants exposed to marijuana.
abstract: BACKGROUND
  Limited data exist regarding the neonatal and neurodevelopmental outcomes of infants exposed to marijuana (MJ) in-utero, particularly among preterm infants. We hypothesized that MJ-exposed preterm infants would have worse neonatal and childhood developmental outcomes compared to MJ-unexposed infants.
  
  
  METHODS
  Secondary analysis of multicenter randomized-controlled trial of antenatal magnesium sulfate for the prevention of cerebral palsy was conducted. Singleton nonanomalous infants delivered <35 weeks exposed to MJ in-utero were compared to MJ-unexposed. Primary neonatal outcome was death, grade 3/4 intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, and/or stage II/III necrotizing enterocolitis before discharge. Primary childhood outcome was death, moderate/severe cerebral palsy, or/and Bayley II Scales <70 at age 2. Backward-stepwise regression used to estimate odds of primary outcomes.
  
  
  RESULTS
  1867 infants met inclusion criteria; 135(7.2%) were MJ-exposed. There were no differences in neonatal (20% vs. 26%, p = 0.14) or childhood (26% vs. 21%, p = 0.21) outcomes in MJ-exposed infants compared to MJ-unexposed infants. In adjusted models, MJ-exposure was not associated with adverse neonatal outcomes (aOR 0.83 95% CI 0.47,1.44) or early childhood outcomes (aOR 1.47, 95% CI 0.97,2.23).
  
  
  CONCLUSIONS
  Among infants born <35 weeks of gestation, MJ-exposure was not associated with adverse neonatal or childhood outcomes. Long-term follow-up studies are needed to assess later childhood neurodevelopmental outcomes following MJ-exposure.
authors.affiliation: a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , University of North Carolina , Chapel Hill , NC , USA.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Dotters-Katz
authors.affiliation: b Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , University of Utah , Salt Lake City , UT , USA.
authors.forename: Marcela C
authors.initials: MC
authors.lastname: Smid
authors.affiliation: a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , University of North Carolina , Chapel Hill , NC , USA.
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Manuck
authors.affiliation: c Department of Obstetrics and Gynecology , Denver Health Medical Center , Denver , CO , USA.|d Department of Obstetrics and Gynecology, University of Colorado School of Medicine , Aurora , CO , USA.
authors.forename: Torri D
authors.initials: TD
authors.lastname: Metz
mesh_terms: D002188:Cannabis / Q000009:adverse effects*; D002547:Cerebral Palsy / Q000151:congenital / Q000453:epidemiology / Q000517:prevention & control; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008297:Male; D002189:Marijuana Abuse / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D009017:Morbidity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000453:epidemiology; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D008278:Magnesium Sulfate
keywords: Marijuana; developmental outcomes; neonatal morbidity; prematurity