CLINICAL QUESTION

Is cannabis use in pregnancy associated with adverse neonatal outcomes?

BOTTOM LINE

Cannabis use in pregnancy is associated with low birth weight (LBW) and small-for-gestational-age (SGA) infants with a dose-response gradient. There are probable small associations with preterm birth or neonatal intensive care unit admission. This information may be useful in counseling patients who are pregnant, especially now that recreational use has been legalized in many states. We can expect that there will be further, mostly observational, studies on this topic. (Level of Evidence = 2b)

SYNOPSIS

The authors report the findings of a retrospective cohort study from the Kaiser Permanente–Northern California integrated health care delivery system, including commercial, Medicare, and Medicaid plans. The study included infants of singleton pregnancies (N = 364,924) born 2011 to 2020 with Kaiser Permanente–Northern California health plan coverage at some point in the pregnancy, at least one prenatal visit, and an affirmative maternal response to a questionnaire about cannabis use or a urine toxicology test result positive for cannabis (done as a routine prenatal laboratory test).