Cannabis Use Raises Risk for Pregnancy-Related Nausea

TOPLINE:

Preconception and prenatal cannabis use were associated with increased odds of both mild and severe nausea and vomiting in pregnancy (NVP), with daily users showing the highest risk. Among 356,343 pregnancies, 11.3% reported preconception cannabis use and 6.5% showed prenatal use, while 3.6% experienced severe NVP and 16% had mild NVP.

METHODOLOGY:

• A cross-sectional observational study conducted at Kaiser Permanente Northern California analyzed data from 356,343 pregnancies between 2011 and 2022, excluding 2020, with universal screening for cannabis use at prenatal care entry (8-10 weeks gestation).
• Researchers identified first-trimester NVP through International Classification of Diseases diagnostic codes, categorizing it as severe (hyperemesis gravidarum), mild (other NVP diagnoses), or none.
• Analysis included both self-reported cannabis use for 1 year before pregnancy (preconception) and self-reported or positive toxicology test results during first trimester (prenatal), with generalized estimating equation multinomial logistic regression used to assess associations.

TAKEAWAY:

• Self-reported preconception cannabis use was associated with greater odds of mild NVP (adjusted odds ratio [aOR], 1.68; 95% CI, 1.59-1.77) and severe NVP (aOR, 2.61; 95% CI, 2.40-2.84) than no preconception use.
• Daily prenatal cannabis use showed even stronger associations with mild NVP (aOR, 1.97; 95% CI, 1.79-2.17) and severe NVP (aOR, 3.80; 95% CI, 3.28-4.39) than no prenatal use.
• Among participants, 61.9% were non-White and 12.8% were younger than 25 years, with 11.3% reporting preconception cannabis use and 6.5% screening positive for prenatal use.

IN PRACTICE:

“Increased NVP could be linked to cannabis withdrawal or cannabinoid hyperemesis syndrome in individuals with frequent preconception or prenatal use, whereas cannabis may be used during early pregnancy to cope with NVP symptoms,” wrote the authors of the study.

SOURCE:

The study was led by Kelly C. Young-Wolff, PhD, MPH, Division of Research, Kaiser Permanente Northern California in Pleasanton, California. It was published online in Obstetrics & Gynecology.

LIMITATIONS:

According to the authors, California legalized medical cannabis use in 2009 and adult-use cannabis in 2016, so findings may not generalize beyond individuals seeking prenatal care in California. Preconception cannabis use was based on self-report and subject to potential recall and underreporting bias. Additionally, prenatal use was assessed during early pregnancy, preventing determination of whether use continued throughout pregnancy or if nonusers began use later in pregnancy.

DISCLOSURES:

This study was supported by National Institute on Drug Abuse grants KO01DA043604 and ROIDA058201 (Young-Wolff), and UG1DA040314 (Cynthia I. Campbell). Campbell disclosed receiving support managed through her institution from the Industry PMR Consortium for postmarketing studies required by the US Food and Drug Administration that assesses risks related to opioid analgesic use. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.