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Maternal Cannabis Use During a Child's Lifetime Associated With Earlier Initiation.

ABSTRACT: INTRODUCTION:Earlier cannabis initiation is associated with more severe neuropsychiatric and social consequences. The authors investigated whether mothers' cannabis use is associated with earlier cannabis initiation by their children. METHODS:Mother and child data were from the National Longitudinal Survey of Youth 1979 (1980-1998 waves) and Child and Young Adults (1988-2014 waves) cohorts, respectively. Cox proportional hazard models assessed the effect of maternal cannabis use prior to a child's adolescence on the child's risk of subsequent cannabis initiation. Models were stratified by race and child's age category (6-16, 17-24, ?25 years). Adjusted analyses controlled for sociodemographic variables. Analyses were conducted in 2017. RESULTS:Median age of cannabis initiation for children of maternal ever users was age 16years compared with age 18years among children of maternal never users. Children of 1-year and multiple-year users were at increased risk of cannabis initiation between ages 6 and 16years (hazard ratio=1.38, p<0.001, and hazard ratio = 1.45, p<0.001, respectively). Effects were slightly stronger among non-Hispanic non-black children. CONCLUSIONS:As cannabis legalization expands across the U.S., adult use may become increasingly normative. This study indicates that maternal cannabis use may be a risk factor for early initiation among their offspring. Preventive interventions should consider strategies to delay initiation among children of cannabis users.

SUBMITTER: Sokol NA

PROVIDER: S-EPMC6481668 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Maternal Cannabis Use During a Child's Lifetime Associated With Earlier Initiation.

Sokol Natasha A NA Okechukwu Cassandra A CA Chen Jarvis T JT Subramanian S V SV Rees Vaughan W VW

American journal of preventive medicine 20180924 5

<h4>Introduction</h4>Earlier cannabis initiation is associated with more severe neuropsychiatric and social consequences. The authors investigated whether mothers' cannabis use is associated with earlier cannabis initiation by their children.<h4>Methods</h4>Mother and child data were from the National Longitudinal Survey of Youth 1979 (1980-1998 waves) and Child and Young Adults (1988-2014 waves) cohorts, respectively. Cox proportional hazard models assessed the effect of maternal cannabis use p ...[more]

PMID: 30262151

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Project description:ImportanceMany studies have evaluated whether in utero cannabis exposure is associated with fetal and neonatal outcomes, yet little is known about whether prenatal cannabis use is associated with maternal health outcomes during pregnancy.ObjectiveTo evaluate whether prenatal cannabis use is associated with maternal health outcomes during pregnancy.Design, setting, and participantsThis population-based retrospective cohort study included pregnancies in Northern California from January 2011 to December 2019 that lasted 20 weeks or longer and were screened for prenatal cannabis use.ExposuresPrenatal cannabis use was defined as any self-reported use during early pregnancy or a positive toxicology test result based on universal screening at entrance to prenatal care (approximately 8-10 weeks' gestation). Self-reported frequency of use (daily, weekly, monthly or less, never, unknown), use defined only by self-report, and use defined only by toxicology test results were examined.Main outcomes and measuresElectronic health record data were used to define the following outcomes: gestational hypertension, preeclampsia, eclampsia, gestational diabetes, gestational weight gain greater and less than guidelines, placenta previa, placental abruption, placenta accreta, and severe maternal morbidity. Adjusted risk ratios (aRRs) were calculated using a modified Poisson regression.ResultsThe sample (n = 316 722 pregnancies; 250 221 unique individuals) included 84 039 (26.5%) Asian/Pacific Islander, 20 053 (6.3%) Black, 83 145 (26.3%) Hispanic, and 118 333 (37.4%) White individuals; the mean (SD) age was 30.6 (5.4) years. Overall, 20 053 (6.3%) screened positive for prenatal cannabis use; 2.9% were positive by self-report, 5.3% by toxicology testing, and 1.8% by both. The frequency of cannabis use was 1930 (0.6%) daily, 2345 (0.7%) weekly, 4892 (1.5%) monthly or less, and 10 886 (3.4%) unknown. Prenatal cannabis use was associated with greater risk of gestational hypertension (aRR, 1.17; 95% CI, 1.13-1.21), preeclampsia (aRR, 1.08; 95% CI, 1.01-1.15), weight gain less than (aRR, 1.05; 95% CI, 1.01-1.08) and greater than (aRR, 1.09; 95% CI, 1.08-1.10) guidelines, and placental abruption (aRR, 1.19; 95% CI, 1.05-1.36). The pattern of results was similar when defining prenatal cannabis use only by self-report or only by toxicology testing, and associations between the frequency of prenatal cannabis use and outcomes varied with outcome.Conclusions and relevanceThe results of this cohort study suggest that prenatal cannabis use was associated with several adverse maternal health outcomes during pregnancy. Continued research is needed to understand whether characteristics of prenatal cannabis use (eg, dose, mode, and timing) moderate these associations.

Project description:BACKGROUND:Factors driving the trend of earlier dialysis initiation for persons with end-stage renal disease are unknown. We wanted to determine the association of the number and type of signs and symptoms with timing of initiation of dialysis in US nursing home residents. STUDY DESIGN:Observational study. SETTING & PARTICIPANTS:We used data from the US Renal Data System linked with the Minimum Data Set, a national registry of nursing home residents. The cohort consisted of 2,402 nursing home residents who initiated dialysis between 1998 and 2000 and had at least 2 recorded clinical assessments in the year before dialysis initiation. PREDICTORS:We evaluated 7 clinical signs and symptoms: dependence in activities of daily living, cognitive function, edema, dyspnea, nutritional problems, vomiting, and body size. OUTCOMES:Earlier dialysis initiation was defined as estimated glomerular filtration rate ? 1 5 mL/min/1.73 m² at the start of dialysis. RESULTS:Median estimated glomerular filtration rate at the start of dialysis was 9.8 (25th-75th percentile, 7.4-13.4) mL/min/1.73 m². After adjustment for age, sex, race, and comorbid conditions, each additional sign or symptom was associated with a higher odds for earlier dialysis initiation (OR, 1.16 per symptom; 95% CI, 1.06-1.28), as was each adversely changing sign or symptom (OR, 1.26 per symptom; 95% CI, 1.16-1.38). The population-attributable risk for earlier dialysis initiation associated with having one or more signs and symptoms of volume overload, cognitive decline, increasing activities of daily living dependence, and weight loss was 31%; volume overload had the largest aggregate population-attributable risk. LIMITATIONS:We lacked information about metabolic indications for dialysis initiation. CONCLUSIONS:Volume overload, cognitive decline, increasing activities of daily living dependence, and weight loss were associated with earlier dialysis initiation; however, these factors explained less than one-third of cases of earlier dialysis initiation in nursing home residents.

Dataset Information

Maternal Cannabis Use During a Child's Lifetime Associated With Earlier Initiation.

Publications

Maternal Cannabis Use During a Child's Lifetime Associated With Earlier Initiation.

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