Use of cannabis during pregnancy and birth outcomes in an Aboriginal birth cohort: a cross-sectional, population-based study

Objectives Indigenous women continue to experience rates of stillbirth, preterm birth and low birth weight, two to three times higher than other women in high-income countries. The reasons for disparities are complex and multifactorial. We aimed to assess the extent to which adverse birth outcomes a...

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Main Authors: Deirdre Gartland, Stephanie J Brown, Karen Glover, Fiona K Mensah, Cathy Leane, Jane Yelland, Jackie Ah Kit, Deanna Stuart-Butler, Donna Weetra, Jonathan Newbury
Format: Article
Language:English
Published: BMJ Publishing Group 2016-02-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/6/2/e010286.full
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author Deirdre Gartland
Stephanie J Brown
Karen Glover
Fiona K Mensah
Cathy Leane
Jane Yelland
Jackie Ah Kit
Deanna Stuart-Butler
Donna Weetra
Jonathan Newbury
author_facet Deirdre Gartland
Stephanie J Brown
Karen Glover
Fiona K Mensah
Cathy Leane
Jane Yelland
Jackie Ah Kit
Deanna Stuart-Butler
Donna Weetra
Jonathan Newbury
author_sort Deirdre Gartland
collection DOAJ
description Objectives Indigenous women continue to experience rates of stillbirth, preterm birth and low birth weight, two to three times higher than other women in high-income countries. The reasons for disparities are complex and multifactorial. We aimed to assess the extent to which adverse birth outcomes are associated with maternal cannabis use and exposure to stressful events and social health issues during pregnancy.Design/setting Cross-sectional, population-based survey of women giving birth to Aboriginal babies in South Australia, July 2011–June 2013. Data include: maternal cannabis use, exposure to stressful events/social health issues, infant birth weight and gestation.Participants 344 eligible women with a mean age of 25 years (range 15–43 years), enrolled in the study. Participants were representative in relation to maternal age, infant birth weight and gestation.Results 1 in 5 women (20.5%) used cannabis during pregnancy, and 52% smoked cigarettes. Compared with mothers not using cannabis or cigarettes, mothers using cannabis had babies on average 565 g lighter (95% CI −762 to −367), and were more likely to have infants with a low birth weight (OR=6.5, 95% CI 3.0 to 14.3), and small for gestational age (OR=3.8, 95% CI 1.9 to 7.6). Controlling for education and other social characteristics, including stressful events/social health issues did not alter the conclusion that mothers using cannabis experience a higher risk of negative birth outcomes (adjusted OR for odds of low birth weight 3.9, 95% CI 1.4 to 11.2).Conclusions The findings provide a compelling case for stronger efforts to address the clustering of risk for adverse outcomes in Aboriginal and Torres Strait Islander communities, and point to the need for antenatal care to address broader social determinants of adverse perinatal outcomes. Integrated responses—collaboratively developed with Aboriginal communities and organisations—that focus on constellations of risk factors, and a holistic approach to addressing social determinants of adverse birth outcomes, are required.
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spelling doaj-art-133fb02d548c4ab6849a4ec9c10d15432025-02-06T20:00:12ZengBMJ Publishing GroupBMJ Open2044-60552016-02-016210.1136/bmjopen-2015-010286Use of cannabis during pregnancy and birth outcomes in an Aboriginal birth cohort: a cross-sectional, population-based studyDeirdre Gartland0Stephanie J Brown1Karen Glover2Fiona K Mensah3Cathy Leane4Jane Yelland5Jackie Ah Kit6Deanna Stuart-Butler7Donna Weetra8Jonathan Newbury9Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, AustraliaDepartment of General Practice, The University of Melbourne, Melbourne, Victoria, AustraliaAdelaide Medical School, The University of Adelaide, Adelaide, South Australia, AustraliaIntergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia4 South Australian Government, Women’s and Children’s Health Network, Adelaide, South Australia, AustraliaMurdoch Childrens Research Institute, Melbourne, Victoria, Australia5Women`s and Children`s Health Network, SA Health, Adelaide, South Australia, Australia5Women`s and Children`s Health Network, SA Health, Adelaide, South Australia, AustraliaWomen and Kids Theme, South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia7Department of Rural Health, The University of Adelaide, Adelaide, South Australia, AustraliaObjectives Indigenous women continue to experience rates of stillbirth, preterm birth and low birth weight, two to three times higher than other women in high-income countries. The reasons for disparities are complex and multifactorial. We aimed to assess the extent to which adverse birth outcomes are associated with maternal cannabis use and exposure to stressful events and social health issues during pregnancy.Design/setting Cross-sectional, population-based survey of women giving birth to Aboriginal babies in South Australia, July 2011–June 2013. Data include: maternal cannabis use, exposure to stressful events/social health issues, infant birth weight and gestation.Participants 344 eligible women with a mean age of 25 years (range 15–43 years), enrolled in the study. Participants were representative in relation to maternal age, infant birth weight and gestation.Results 1 in 5 women (20.5%) used cannabis during pregnancy, and 52% smoked cigarettes. Compared with mothers not using cannabis or cigarettes, mothers using cannabis had babies on average 565 g lighter (95% CI −762 to −367), and were more likely to have infants with a low birth weight (OR=6.5, 95% CI 3.0 to 14.3), and small for gestational age (OR=3.8, 95% CI 1.9 to 7.6). Controlling for education and other social characteristics, including stressful events/social health issues did not alter the conclusion that mothers using cannabis experience a higher risk of negative birth outcomes (adjusted OR for odds of low birth weight 3.9, 95% CI 1.4 to 11.2).Conclusions The findings provide a compelling case for stronger efforts to address the clustering of risk for adverse outcomes in Aboriginal and Torres Strait Islander communities, and point to the need for antenatal care to address broader social determinants of adverse perinatal outcomes. Integrated responses—collaboratively developed with Aboriginal communities and organisations—that focus on constellations of risk factors, and a holistic approach to addressing social determinants of adverse birth outcomes, are required.https://bmjopen.bmj.com/content/6/2/e010286.full
spellingShingle Deirdre Gartland
Stephanie J Brown
Karen Glover
Fiona K Mensah
Cathy Leane
Jane Yelland
Jackie Ah Kit
Deanna Stuart-Butler
Donna Weetra
Jonathan Newbury
Use of cannabis during pregnancy and birth outcomes in an Aboriginal birth cohort: a cross-sectional, population-based study
BMJ Open
title Use of cannabis during pregnancy and birth outcomes in an Aboriginal birth cohort: a cross-sectional, population-based study
title_full Use of cannabis during pregnancy and birth outcomes in an Aboriginal birth cohort: a cross-sectional, population-based study
title_fullStr Use of cannabis during pregnancy and birth outcomes in an Aboriginal birth cohort: a cross-sectional, population-based study
title_full_unstemmed Use of cannabis during pregnancy and birth outcomes in an Aboriginal birth cohort: a cross-sectional, population-based study
title_short Use of cannabis during pregnancy and birth outcomes in an Aboriginal birth cohort: a cross-sectional, population-based study
title_sort use of cannabis during pregnancy and birth outcomes in an aboriginal birth cohort a cross sectional population based study
url https://bmjopen.bmj.com/content/6/2/e010286.full
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