In the Journals

Pregnant women with nausea, vomiting more likely to use marijuana

Despite national guidelines recommending against the use of marijuana during pregnancy and its unknown health effects, women with severe or mild nausea and vomiting in pregnancy had increased odds of using marijuana during their pregnancy, according to findings published in JAMA Internal Medicine.

“Use of marijuana, an antiemetic, is increasing among pregnant women, and data from small surveys indicate that women self-report using marijuana to alleviate nausea and vomiting in pregnancy,” Kelly C. Young-Wolff, PhD, MPH, from Kaiser Permanente Northern California, and colleagues wrote.

Young-Wolff and colleagues evaluated whether nausea and vomiting in pregnancy is associated with increased prenatal marijuana use among a large cohort of pregnant women aged 12 years and older from the Kaiser Permanente Northern California health care system (n = 220,510).

Participants were screened for prenatal marijuana use via a self-reported substance use questionnaire and urine toxicologic test at approximately 8 weeks gestation. Positive toxicologic tests were confirmed with laboratory testing.

The researchers used the International Classification of Disease, Ninth Revision, Clinical Modification, and Tenth Revision, Clinical Modification to determine if participants experienced nausea and vomiting during the first trimester of pregnancy.

About 8% of participants reported using marijuana in the year prior to pregnancy. Of those with positive results for marijuana use during the first trimester, 0.7% were positive on self-report only, 3.1% were positive on toxicologic test finding only and 1.5% were positive on both.

Overall, 2.3% of participants experienced severe nausea and vomiting in pregnancy and 15.3% experienced mild nausea and vomiting. Self-report and toxicologic tests showed that 5.3% of participants used marijuana during pregnancy.

The prevalence of prenatal marijuana use was higher among women with severe (11%) and mild (8.4%) nausea and vomiting in pregnancy than those who did not experience nausea and vomiting (4.5%). Additionally, women with severe (adjusted OR = 3.8; 95% CI, 3.19-4.52) nausea and vomiting in pregnancy were nearly four times as likely — and those with mild (aOR = 2.37; 95% CI, 2.17-2.59) nausea and vomiting in pregnancy were twice as likely — to use marijuana prenatally, compared with those without nausea and vomiting.

“Although results are consistent with the hypothesis that women use marijuana to self-medicate for nausea and vomiting in pregnancy, marijuana use may also contribute to nausea and vomiting in pregnancy, or clinicians may diagnose nausea and vomiting in pregnancy more frequently among women who report using marijuana to treat it,” Young-Wolff and colleagues concluded.

“The health effects of prenatal marijuana use are unclear, and national guidelines recommend that pregnant women discontinue use,” they added. “Patients with nausea and vomiting in pregnancy should be screened for marijuana use and educated about effective and safe nausea and vomiting in pregnancy treatments.” – by Alaina Tedesco

 

Disclosures: The authors report no relevant financial disclosures.

Despite national guidelines recommending against the use of marijuana during pregnancy and its unknown health effects, women with severe or mild nausea and vomiting in pregnancy had increased odds of using marijuana during their pregnancy, according to findings published in JAMA Internal Medicine.

“Use of marijuana, an antiemetic, is increasing among pregnant women, and data from small surveys indicate that women self-report using marijuana to alleviate nausea and vomiting in pregnancy,” Kelly C. Young-Wolff, PhD, MPH, from Kaiser Permanente Northern California, and colleagues wrote.

Young-Wolff and colleagues evaluated whether nausea and vomiting in pregnancy is associated with increased prenatal marijuana use among a large cohort of pregnant women aged 12 years and older from the Kaiser Permanente Northern California health care system (n = 220,510).

Participants were screened for prenatal marijuana use via a self-reported substance use questionnaire and urine toxicologic test at approximately 8 weeks gestation. Positive toxicologic tests were confirmed with laboratory testing.

The researchers used the International Classification of Disease, Ninth Revision, Clinical Modification, and Tenth Revision, Clinical Modification to determine if participants experienced nausea and vomiting during the first trimester of pregnancy.

About 8% of participants reported using marijuana in the year prior to pregnancy. Of those with positive results for marijuana use during the first trimester, 0.7% were positive on self-report only, 3.1% were positive on toxicologic test finding only and 1.5% were positive on both.

Overall, 2.3% of participants experienced severe nausea and vomiting in pregnancy and 15.3% experienced mild nausea and vomiting. Self-report and toxicologic tests showed that 5.3% of participants used marijuana during pregnancy.

The prevalence of prenatal marijuana use was higher among women with severe (11%) and mild (8.4%) nausea and vomiting in pregnancy than those who did not experience nausea and vomiting (4.5%). Additionally, women with severe (adjusted OR = 3.8; 95% CI, 3.19-4.52) nausea and vomiting in pregnancy were nearly four times as likely — and those with mild (aOR = 2.37; 95% CI, 2.17-2.59) nausea and vomiting in pregnancy were twice as likely — to use marijuana prenatally, compared with those without nausea and vomiting.

“Although results are consistent with the hypothesis that women use marijuana to self-medicate for nausea and vomiting in pregnancy, marijuana use may also contribute to nausea and vomiting in pregnancy, or clinicians may diagnose nausea and vomiting in pregnancy more frequently among women who report using marijuana to treat it,” Young-Wolff and colleagues concluded.

“The health effects of prenatal marijuana use are unclear, and national guidelines recommend that pregnant women discontinue use,” they added. “Patients with nausea and vomiting in pregnancy should be screened for marijuana use and educated about effective and safe nausea and vomiting in pregnancy treatments.” – by Alaina Tedesco

 

Disclosures: The authors report no relevant financial disclosures.