Cannabis & Nicotine in Pregnancy: Infant Mortality Risk

The combined hazards of consuming both cannabis and nicotine while pregnant are brought to light by a recent study. According to the study, using these drugs at the same time greatly raises the risk of poor neonatal outcomes, including preterm birth, small gestational size, and infant death.

To reduce these risks, the researchers stress the importance of improved preconception and prenatal counseling. The results of the study support increased knowledge and focused instruction to assist expectant mothers in comprehending and navigating the risks associated with concurrent substance use.

Important Details:

1. Increased Risk with Dual Use: The mortality risk for children born to moms who use both cannabis and nicotine is double that of those who use either substance alone, and it is four times higher than that of non-users.
2. Need for Better Counseling: The study emphasizes how important it is that medical professionals talk to pregnant patients about the unique hazards associated with using both cannabis and nicotine.
3. Ongoing Research and Interventions: The study backs up ongoing initiatives such as vitamin C supplementation during pregnancy, which has been found to help reduce respiratory problems in smokers’ offspring.

Oregon Health and Science University is the source.

Researchers from Oregon Health & Science University have found that, as compared to using either drug alone, pregnant women who use both cannabis and nicotine are substantially more likely to have babies who have poor health outcomes.

According to the study, which was published in JAMA Network Open today, babies whose mothers used both drugs during their pregnancies were more likely to be tiny for gestational size, to be delivered prematurely, or even to die.

Jamie Lo, M.D., M.C.R., associate professor of obstetrics and gynecology (maternal-fetal medicine) in the OHSU School of Medicine and Division of Reproductive and Developmental Sciences at OHSU’s Oregon National Primate Research Center, said that the study’s corresponding author. “The findings suggest the need for more effective clinical counseling early on, during the preconception and prenatal periods.” Approximately half of pregnant women who use cannabis also use tobacco or nicotine products.

“With the growing legalization of cannabis around the country, there is often a perception that cannabis is safe in pregnancy,” Lo said.

“Because we know that many people who use cannabis often use tobacco or nicotine products, we wanted to better understand the potential health implications on both the pregnant individual and the infant.

“There is still a great deal of stigma around the use of substances during pregnancy,” she continued.

“With limited research to support official clinical recommendations, it can be a difficult topic for both patients and providers to navigate. Our hope is that this research supports more open and productive conversations that ultimately result in a healthier pregnancy.”

Researchers examined vital statistics and hospital discharge data from over 3 million pregnant patients who had a history of cannabis and/or nicotine use.

The risk was larger when cannabis and nicotine were used combined than when they were used alone. Individuals who used cannabis or nicotine alone had higher rates of preterm delivery, small gestational sizes, and infant and neonatal deaths compared to non-users.

The most striking finding was that infant mortality was four times greater among cannabis and nicotine users than in non-users. When compared to individuals who used cannabis or nicotine exclusively, the rate was almost two times greater.

According to the research team, these results can aid medical practitioners in preconception and prenatal counseling, particularly concerning the advantages of stopping at least one of the two substances.

Additionally, they are in favor of increased initiatives to inform expectant mothers about the dangers of nicotine and cannabis.

“We hope that pregnant individuals can abstain from using both cannabis and nicotine products. However, we acknowledge the complexities of individual circumstances may make this goal challenging, and for some patients is simply not realistic,” said Adam Crosland, M.D., M.P.H., assistant professor of obstetrics and gynecology in the OHSU School of Medicine and lead author of the study.

“We always strive to meet people where they are and support patients with evidence-based recommendations and treatment options that are both patient-centered and promote the healthiest outcomes possible.

“Our findings suggest that avoiding the use of just one of these substances can decrease the pregnancy risks we see when both substances are used together, which is a critical piece of information providers can highlight when counseling patients.”

Along with Eliot Spindel, M.D., Ph.D., and Cindy McEvoy, M.D., M.C.R., the multidisciplinary research team is looking into ways to lessen the respiratory risks associated with smoking during pregnancy for their offspring.

McEvoy’s group discovered that giving pregnant women who are unable to stop smoking vitamin C supplements greatly enhances the respiratory health and airway function of their children; additionally, these benefits last until the age of five, and the children are followed up with until adolescence.

To better inform pregnant patients about the risks associated with usage, researchers will keep examining the consequences of combined cannabis and nicotine use, including the impact of potency, frequency, and timing.

The group will also keep investigating the feasibility of prenatal therapies, such as vitamin C supplements, as well as alternative forms of care for women who are unable to give up smoking while expecting.

Finances: The National Institute on Drug Abuse, a division of the National Institutes of Health, provided funding for this research under grants DP1DA056493-01 and P51OD011092. The authors alone are responsible for the information in this release, which does not represent the official opinions of the National Institutes of Health.

For more information: Risk of Adverse Neonatal Outcomes After Combined Prenatal Cannabis and Nicotine Exposure, JAMA, doi:10.1001/jamanetworkopen.2024.10151