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Grand Rounds

Does Daily Marijuana Use in Pregnancy Impair Fetal Growth?

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BACKGROUND AND PURPOSE:

  • Brar et al. (Journal of Maternal-Fetal & Neonatal Medicine, 2019) studied the effect of daily marijuana use on fetal sonographic growth parameters and placental perfusion  

METHODS:

  • Retrospective cohort study (2013 to 2017)
  • Participants
    • Confirmed viable pregnancy on ultrasound | Between 18 and 52 years of age | Singleton and non-syndromic  
    • Self-identified daily marijuana users or nonusers
    • Exclusion: Other risk factors for FGR
  • Study design
    • Daily marijuana users were gestational aged matched to controls
    • Comparisons included
      • Maternal demographics
      • Fetal biometry
      • Nuchal translucency
      • Umbilical artery Dopplers
    • Intrauterine growth restriction: Defined as EFW <10th percentile  

RESULTS:

  • 442 pregnant women | 55 first trimester daily marijuana users | 195 second trimester daily marijuana users | 192 third trimester daily marijuana users
  • First trimester
    • CRL: No difference
    • NT: No difference
  • Second trimester
    • Biometry: No differences
    • Umbilical artery S/D ratios: Higher in marijuana users (4.02 vs 3.92; p = 0.024)
  • Third trimester:
    • HC: Smaller head circumference, measured in percentile, found in marijuana users (37.55 vs 51.49; p < 0.0001) | Similar finding for AC
    • Growth restriction: Higher number in the marijuana users group (26/192 vs 6 6/192; p=0 .002)
  • Umbilical artery SD ratios: Higher in marijuana users (3.52 vs 3.12; p = 0.0001)
    • Four cases of absent and reversed end diastolic flow were observed in marijuana users, while no cases were observed in controls

CONCLUSION:

  • Daily marijuana use is associated with impaired fetal growth and placental vascular resistance compared to non-users in the 2nd and 3rd trimesters
  • These findings confirm current recommendations that “marijuana use in pregnancy should be discouraged due to its association with harmful effects on the pregnancy”

Learn More – Primary Sources:

Effect of intrauterine marijuana exposure on fetal growth patterns and placental vascular resistance

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Related ObG Topics:

Does Marijuana Affect Time to Pregnancy?
Marijuana Detection in Breast Milk: Does Route and Timing Make a Difference?
Safe Passage Study: Prenatal Alcohol Exposure and Cognitive Abilities at 4 years of Age

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