@article{11e863e870c0418c847175126645fbf3,
title = "Maternal persistent marijuana use and cigarette smoking are independently associated with shorter gestational age",
abstract = "Background: Research assessing the effects of marijuana use on preterm birth has found mixed results, in part, due to lack of attention to the role of maternal tobacco smoking during pregnancy. Objectives: The study objective was to investigate whether maternal marijuana use was independently associated with gestational age, preterm birth, and two preterm birth subtypes (spontaneous vs clinician-initiated). Methods: Participants included 8261 mother-newborn pairs from the Boston Birth Cohort. Information on gestational age was collected from electronic medical records. Marijuana use and tobacco smoking during pregnancy were assessed through a standard questionnaire after birth. Linear and log-linear regression models were used to assess associations between marijuana use with and without tobacco smoking during pregnancy and the outcomes of interest. Results: Of the 8261 mothers, 27.5% had preterm births. About 3.5% of mothers with term deliveries and 5.2% of mothers with preterm births used marijuana during pregnancy. Marijuana use and cigarette smoking were independently associated with a decrease in gestational age by 0.50 weeks (95% confidence interval [CI] −0.87, −0.13) and 0.52 weeks (95% CI −0.76, −0.28), respectively. Marijuana use during early or late pregnancy was associated with a similar decrease in gestational age by 0.50 weeks. When we examined the effects on the preterm birth subtypes, simultaneous marijuana use and tobacco smoking were associated with higher risk of spontaneous preterm birth (RR 1.64, 95% CI 1.23, 2.18). The elevated risk was not observed with clinician-initiated preterm birth. Conclusions: In this high-risk US population, maternal marijuana use and cigarette smoking during pregnancy were independently associated with shorter gestational age. When we examined the effects on preterm birth subtypes, the elevated risk was only observed with spontaneous preterm birth.",
keywords = "cannabis, minority health, preterm birth, smoking, tobacco",
author = "Nobutoshi Nawa and Garrison-Desany, {Henri M.} and Yoona Kim and Yuelong Ji and Xiumei Hong and Guoying Wang and Colleen Pearson and Zuckerman, {Barry S.} and Xiaobin Wang and Surkan, {Pamela J.}",
note = "Funding Information: We thank the study participants for taking part in the study. We are also grateful for the dedication of the field team at the Department of Pediatrics, Boston University School of Medicine, and for the help of the obstetric nursing staff at Boston Medical Center. Dr Hong is partially supported by Hopkins Population Center (NICHD R24HD042854). Funding Information: The Boston Birth Cohort (the parent study) is supported in part by the National Institutes of Health (NIH) under grants number R21HD085556, R21ES011666, R21HD066471, R01HD086013 and 2R01HD041702; and by the March of Dimes PERI under grants 20‐FY02‐56 and 21‐FY07‐605; and by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under Grant Number R40MC27443 and cooperative agreement UJ2MC31074. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by NIH, HRSA or HHS the US Government. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. Funding Information: The Boston Birth Cohort (the parent study) is supported in part by the National Institutes of Health (NIH) under grants number R21HD085556, R21ES011666, R21HD066471, R01HD086013 and 2R01HD041702; and by the March of Dimes PERI under grants 20-FY02-56 and 21-FY07-605; and by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under Grant Number R40MC27443 and cooperative agreement UJ2MC31074. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by NIH, HRSA or HHS the US Government. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. We thank the study participants for taking part in the study. We are also grateful for the dedication of the field team at the Department of Pediatrics, Boston University School of Medicine, and for the help of the obstetric nursing staff at Boston Medical Center. Dr Hong is partially supported by Hopkins Population Center (NICHD R24HD042854). Publisher Copyright: {\textcopyright} 2020 John Wiley & Sons Ltd",
year = "2020",
month = nov,
day = "1",
doi = "10.1111/ppe.12686",
language = "English (US)",
volume = "34",
pages = "696--705",
journal = "Paediatric and Perinatal Epidemiology",
issn = "0269-5022",
publisher = "Wiley-Blackwell",
number = "6",
}