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Am J Perinatol 2022; 39(05): 546-553
DOI: 10.1055/s-0040-1717092
Original Article

Maternal Marijuana Exposure, Feto-Placental Weight Ratio, and Placental Histology

Torri D. Metz
1   University of Utah Health, Salt Lake City, Utah
,
Amanda A. Allshouse
1   University of Utah Health, Salt Lake City, Utah
,
Halit Pinar
2   Brown University, Providence, Rhode Island
,
Michael Varner
1   University of Utah Health, Salt Lake City, Utah
,
Marcela C. Smid 
1   University of Utah Health, Salt Lake City, Utah
,
Carol Hogue
3   Emory University, Atlanta, Georgia
,
Donald J. Dudley
4   University of Virginia School of Medicine, Charlottesville, Virginia
,
Radek Bukowski
5   University of Texas at Austin, Dell Medical School, Austin, Texas
,
George R. Saade
6   University of Texas Medical Branch, Galveston, Texas
,
Robert L. Goldenberg
7   Columbia University, New York City, New York
,
Uma Reddy
8   Yale University, New Haven, Connecticut
,
Robert M. Silver
1   University of Utah Health, Salt Lake City, Utah
› Author Affiliations Funding This study received financial support from U.S. Department of Health and Human Services, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development (5K12HD001271-18). T.D.M. was supported by the National Institute on Child Health and Human Development (NICHD) under award number 5K12HD001271 during the completion of this work. M.C.S. was supported by the NICHD under award number 1K12HD085816 during the completion of this work.
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Abstract

Objective Marijuana use is associated with placenta-mediated adverse pregnancy outcomes including fetal growth restriction, but the mechanism remains uncertain. The objective was to evaluate the association between maternal marijuana use and the feto-placental weight ratio (FPR). Secondarily, we aimed to compare placental histology of women who used marijuana to those who did not.

Study Design This was a secondary analysis of singleton pregnancies enrolled in a multicenter and case–control stillbirth study. Prior marijuana use was detected by electronic medical record abstraction or cord homogenate positive for 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid. Prior tobacco use was detected by self-report or presence of maternal serum cotinine. Stillbirths and live births were considered separately. The primary outcome was FPR. Association of marijuana use with FPR was estimated with multivariable linear modeling adjusted for fetal sex, preterm birth, and tobacco use. Comparisons between groups for placental histology were made using Chi-square and stratified by live birth and stillbirth, term and preterm deliveries, and fetal sex.

Results Of 1,027 participants, 224 were stillbirths and 803 were live births. Overall, 41 (4%) women used marijuana during the pregnancy. The FPR ratio was lower among exposed offspring but reached statistical significance only for term stillbirths (mean 6.84 with marijuana use vs. mean 7.8 without use, p < 0.001). In multivariable modeling, marijuana use was not significantly associated with FPR (p = 0.09). There were no differences in histologic placental features among those with and without marijuana use overall or in stratified analyses.

Conclusion Exposure to marijuana may not be associated with FPR. Similarly, there were no placental histologic features associated with marijuana exposure. Further study of the influence of maternal marijuana use on placental development and function is warranted to better understand the association between prenatal marijuana use and poor fetal growth.

Key Points

  • Maternal marijuana exposure was not associated with the feto-placental weight ratio.

  • Marijuana exposure was not associated with differences in placental histology.

  • Concerning trend toward lower feto-placental weight ratios among marijuana-exposed stillbirths.

Keywords

placenta - marijuana - feto-placental ratio - stillbirth

Note

This study was presented as a poster at the Society for Reproductive Investigation Annual Meeting, San Diego, CA, February 3, 2018.




Publication History

Received: 21 August 2020

Accepted: 23 August 2020

Article published online:
24 September 2020

© 2020. Thieme. All rights reserved.

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