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Prenatal cannabis use disorder and gastroschisis in California, 2007-19
Erin Delker1, Rebecca J Baer1,2, Ann E Kelly1
1Department of Pediatrics, University of California San Diego, San Diego, CA, USA.
Insights
Prenatal cannabis use disorder is associated with a higher risk of gastroschisis, a birth defect. This association is strongest in mothers over 34 years old.
Area of Science:
- Perinatal health
- Congenital anomalies
- Reproductive health
Background:
- Gastroschisis is a congenital abdominal wall defect with unknown causes.
- Recent gastroschisis prevalence trends suggest environmental or behavioral factors.
- Investigating prenatal substance use, specifically cannabis use disorder, is crucial.
Purpose of the Study:
- To examine the association between prenatal cannabis use disorder and gastroschisis.
- To determine if maternal age modifies this association.
Main Methods:
- Utilized the Study of Outcomes of Mothers and Infants cohort (2007-2019).
- Included over 5.7 million singleton live births in California.
- Measured cannabis use disorder and gastroschisis using diagnosis and procedure codes.
Main Results:
- Prevalence of cannabis use disorder was approximately 1%.
- Gastroschisis prevalence was higher in infants exposed to cannabis use disorder (0.14% vs. 0.06%).
- A positive association was observed (aRR=1.3-1.5), particularly in mothers over 34 years old (aRR=2.5).
Conclusions:
- Confirms a positive association between prenatal cannabis exposure and gastroschisis.
- The association is significantly stronger in mothers older than 34.
- Further research is needed to establish causality and understand age-related variations.
Background:
Gastroschisis is a congenital anomaly of the abdominal wall with an unknown aetiology. Recent trends in the prevalence of gastroschisis suggest that changing environmental or behavioural factors may contribute. We examined whether prenatal cannabis use disorder was associated with gastroschisis.
Methods:
The Study of Outcomes of Mothers and Infants is a population-based cohort compiled of California birth records that have been linked to Department of Health Care Access and Information hospitalization, emergency department and ambulatory surgery records. We included 2007-19 singleton live births (n = 5 774 656). Cannabis use disorder was measured by diagnosis codes at any visit during pregnancy or at birth. Gastroschisis was measured by diagnosis or surgical repair procedure codes at birth or during the first year of life.
Results:
The prevalence of cannabis use disorder was about 1%. The prevalence of gastroschisis was 0.14% and 0.06% among those with and without cannabis use disorder, respectively. There were positive associations between cannabis use disorder and gastroschisis when using a multivariable model [adjusted risk ratio (aRR) = 1.3, 95% confidence interval (CI) 1.0, 1.7) and a matched sample approach (aRR = 1.5, 95% CI 1.1, 2.1). The association varied by maternal age and was largest among people aged >34 years (aRR = 2.5, 95% CI 1.0, 5.8).
Conclusions:
We confirm findings of a positive association between cannabis exposure and gastroschisis and add that it is strongest when maternal age is greater than 34 years. More investigation into whether the association is causal, and why the association varies by maternal age, is encouraged.
