67 - Marijuana Use During Pregnancy: Associated Factors and Neonatal Outcomes

Poster Number: 67
Publication Number: 67.429

Esther K.. Chung, University of Washington School of Medicine, Seattle, WA, United States; Pearl Chang, Seattle Children's, Seattle, WA, United States; Neera Goyal, Nemours Children's Hospital, Philadelphia, PA, United States

Background: Marijuana use during pregnancy is increasing as a growing number of states legalize use. Despite national recommendations to abstain from marijuana/cannabis use during pregnancy, up to 4.7% of pregnant women report use. Adverse neonatal health outcomes associated with perinatal marijuana use include preterm birth and low birthweight.

Objective: 1) Describe factors associated with prenatal marijuana use, and 2) determine whether prenatal marijuana use predicts exclusive breastfeeding and/or adverse neonatal outcomes.

Design/Methods: This national study is based on a cross-sectional survey of postpartum mother-infant dyads from 15 hospitals* via the Academic Pediatric Association's (APA's) Better Outcomes through Research for Newborns (BORN) network from June 2021 to August 2022. Participants completed a self-administered questionnaire to assess marijuana use and sociodemographic information; and chart reviews were conducted to obtain clinical information about the pregnancy, breastfeeding, and neonatal outcomes, including preterm (< 37 weeks gestation), small for gestational age (SGA), and low birthweight (< 2500 gms).

Results: The study population consisted of 488 mothers who identified as 50% white/Caucasian, 23% Black/African American, 11% Asian/Native Hawaiian or Pacific Islander, 12% Hispanic, 1% American Indian/Alaska Native, and 3% other. Participants were largely > 30 yrs (60%), educated beyond high school (HS; 83%), had private insurance (62%), and received first-trimester prenatal care (90%). The majority of mothers reported ever using marijuana (60%), and 9% reported use during pregnancy and 4% in the past 30 days. Compared to those without prenatal marijuana use, those with use were more likely to identify as Black (38% vs 21%) or < 30 yrs old (67% v 37%), have < HS education (38% v 14%) or public/no insurance (71% v 35%), and start use prior to 18 yrs (62% v 31%). Prenatal marijuana use also was associated with a lower rate of exclusive breastfeeding (44% v 61%). For all comparisons, p < 0.05. There was no association between prenatal marijuana use and preterm birth, SGA, or low birthweight.

Conclusion(s): This multi-site study with a racially and ethnically diverse population demonstrates that marijuana use during pregnancy is common, particularly among mothers from marginalized and under-resourced populations and who started use during childhood. Marijuana use during pregnancy was associated with a lower likelihood of exclusive breastfeeding. Greater efforts are needed to raise awareness and address marijuana use prevention during pregnancy in order to optimize neonatal outcomes.

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