In a recent study, researchers from Oregon Health & Science University have reported that combining cannabis and nicotine use during pregnancy significantly elevates the risk of adverse health outcomes for newborns compared to using either substance alone (1^✔ ✔Trusted Source
Cannabis, nicotine use during pregnancy increases rate of infant death fourfold

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Published in JAMA Network Open, the study revealed that infants born to mothers who used both substances throughout pregnancy faced a heightened risk of being small for gestational age, experiencing preterm delivery, or even mortality.

Raising Awareness: The Intersection of Cannabis, Nicotine, and Pregnancy Health

Given that around half of pregnant individuals who use cannabis also use tobacco or nicotine products, the findings underscore the importance of more effective clinical counseling, particularly during the preconception and prenatal stages. Jamie Lo, M.D., M.C.R. The study’s corresponding author and associate professor of obstetrics and gynecology (maternal-fetal medicine) at OHSU School of Medicine and Division of Reproductive and Developmental Sciences at OHSU’s Oregon National Primate Research Center, emphasized the necessity for early intervention.

“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.”

Mitigating Risks: Insights into Combined Cannabis and Nicotine Use During Pregnancy

Researchers evaluated hospital discharge data and vital statistics from more than 3 million pregnant patients with documented cannabis and nicotine use. Compared with people who didn’t use any substances, those using cannabis or nicotine alone had increased rates of infant and newborn death, small gestational size and preterm delivery — but the risk was even higher when both cannabis and nicotine were used together.

Most notable was the rate of infant death, which was four times higher in users of both cannabis and nicotine compared with non-users. The rate was nearly two times higher compared with users of just cannabis or nicotine alone.

The research team says these findings can help guide health care professionals with preconception and prenatal counseling, especially regarding the benefits of quitting at least one of the two substances. They also support expanded efforts to educate pregnant people about the risks of cannabis and nicotine.

“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 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.”

The multidisciplinary research team also included Eliot Spindel, M.D., Ph.D., and Cindy McEvoy, M.D., M.C.R., who are investigating how to mitigate the negative respiratory outcomes among children born to parents who smoke during pregnancy. McEvoy’s team found that vitamin C supplementation to pregnant women unable to quit smoking cigarettes significantly improves airway function and respiratory health in their offspring; moreover, these improved outcomes persist through age 5 and these children are in continued follow-up through adolescence.

Looking ahead, researchers will continue to investigate the effects of combined cannabis and nicotine use — including the influence of potency, frequency and timing — in order to better educate pregnant patients about the harms of use. Additionally, the team will continue to explore the viability of prenatal interventions, such a vitamin C supplementation, and other treatment options for individuals who are unable to quit smoking during their pregnancy.

This work was supported by the National Institute on Drug Abuse, part of the National Institutes of Health, under grants DP1DA056493-01 and P51OD011092. The content presented in this release is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health.

Reference:

1. Cannabis, nicotine use during pregnancy increases rate of infant death fourfold – (https://news.ohsu.edu/2024/05/07/cannabis-nicotine-use-during-pregnancy-increases-rate-of-infant-death-fourfold)

Source-Eurekalert