Cannabis Use During Pregnancy Linked to More Severe Form of a Serious Birth Defect | Research

The takeaway

Maternal cannabis use was associated with 2.6 times higher odds of complex gastroschisis (the more severe form with bowel complications) compared to simple gastroschisis, suggesting it may worsen this birth defect.

OB-GYNs, pediatric surgeons, pregnant individuals, and birth defect researchers

What the researchers found

After adjusting for other substance exposures, cannabis use was associated with complex gastroschisis (adjusted OR=2.64), and recurrent urinary tract infections showed an even stronger association (RaR=3.78) — both identified as potentially modifiable risk factors.

Why it matters

Gastroschisis is increasing globally, and while we know what predisposes to it, we didn't know what makes some cases more severe — cannabis exposure may be a modifiable factor that worsens outcomes.

The numbers in context

194 cases total (80% simple, 20% complex); adjusted OR for cannabis: 2.64; recurrent UTI rate ratio: 3.78; no significant effect from smoking, narcotics, alcohol alone.

How the study worked

Retrospective analysis of 194 gastroschisis cases (155 simple, 39 complex) at a tertiary hospital from 1991-2022, comparing maternal risk factors between simple and complex forms using logistic and Poisson regression.

What this study cannot tell us

Small number of complex cases (n=39); single-center retrospective design; substance use from medical records likely underreported; cannot establish causation.

How to read the evidence

Small single-center retrospective study with limited complex cases; associations are suggestive but require larger multi-center validation.

When this study was published

Published in 2026 using 30+ years of data (1991-2022), one of the first studies to examine risk factors for gastroschisis severity.

The bigger picture

This is unique because it looks at severity, not just occurrence — even if cannabis doesn't cause gastroschisis, it may worsen outcomes by promoting bowel complications like necrosis and atresia.

Questions still open

Through what mechanism might cannabis exposure promote bowel complications in gastroschisis? Would these findings replicate in larger multi-center studies?

Common questions

What is gastroschisis?

Gastroschisis is a birth defect where the baby's intestines protrude through an opening in the abdominal wall. The 'complex' form involves additional bowel damage like necrosis or atresia, requiring more extensive surgery.

Can cannabis use during pregnancy cause birth defects?

This study didn't find cannabis caused gastroschisis, but among babies who had it, maternal cannabis use was linked to 2.6x higher odds of the more severe complex form with bowel complications.

Read the original research

Maternal risk factors associated with complex gastroschisis: Cannabis exposure and recurrent urinary tract infections may be modifiable targets.

Journal of pediatric surgery, 163000

View on PubMed ↗Publisher’s paper ↗

Citation

Awolaran, Olugbenga; MacGregor, Kaitlyn; Lum Min, Suyin A; Keijzer, Richard. (2026). Maternal risk factors associated with complex gastroschisis: Cannabis exposure and recurrent urinary tract infections may be modifiable targets.. Journal of pediatric surgery, 163000. https://doi.org/10.1016/j.jpedsurg.2026.163000