Prenatal Cannabis Use Disorder Linked to 40% Higher Risk of Infant Death in First Year
Among 34,544 California births with maternal cannabis use disorder, infant mortality in the first year was 1.0% compared to 0.4% without CUD, with the excess risk driven by perinatal conditions and sudden unexpected infant death.
Quick Facts
What This Study Found
Infant death in the first year was more common with maternal CUD (1.0% vs 0.4%; adjusted RR: 1.4, 95% CI: 1.2-1.6). The increased risk was attributable specifically to perinatal conditions and sudden unexpected infant death (SUID). After adjustment for sociodemographics, psychiatric comorbidities, and other substance use, there was no increased risk of infant hospitalizations or emergency department visits.
Key Numbers
34,544 births with CUD (1.0% of all births); infant death 1.0% vs 0.4%; aRR 1.4 (95% CI: 1.2-1.6); excess deaths from perinatal conditions and SUID; CUD prevalence increased over study period; no increased ER visits or hospitalizations
How They Did This
Population-based retrospective cohort study of all singleton live births in California from 2011-2018 using hospital discharge data linked with vital statistics. Cannabis use disorder classified from ICD codes. Adjusted for sociodemographic variables, psychiatric comorbidities, and other substance use disorders.
Why This Research Matters
While previous research has focused on birth outcomes like preterm delivery, this study extends the risk window to the entire first year of life. The link to sudden unexpected infant death is particularly concerning and could inform postnatal monitoring recommendations.
The Bigger Picture
The finding that excess infant mortality is driven by SUID raises questions about whether prenatal cannabis exposure affects infant arousal responses or whether postnatal factors associated with CUD (smoking, unsafe sleep environments) mediate the risk.
What This Study Doesn't Tell Us
CUD diagnosed by ICD codes may capture more severe cases than typical cannabis use. Cannot separate the effects of cannabis itself from associated behaviors and socioeconomic factors. Adjusted models may not capture all confounding. No information on postnatal cannabis or other substance use.
Questions This Raises
- ?Does prenatal cannabis exposure directly affect infant arousal mechanisms?
- ?Is the SUID risk mediated by postnatal factors like co-sleeping or secondhand smoke?
- ?Would enhanced safe-sleep education for cannabis-using mothers reduce this risk?
Trust & Context
- Key Stat:
- 1.0% vs 0.4% infant mortality
- Evidence Grade:
- Large population-based cohort with administrative data and adjustment for multiple confounders, though ICD-coded CUD may not represent typical cannabis use
- Study Age:
- 2023 study
- Original Title:
- Prenatal cannabis use disorder and infant hospitalization and death in the first year of life.
- Published In:
- Drug and alcohol dependence, 242, 109728 (2023)
- Authors:
- Bandoli, Gretchen(8), Delker, Erin(3), Schumacher, Benjamin T, Baer, Rebecca J, Kelly, Ann E, Chambers, Christina D
- Database ID:
- RTHC-04396
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Does cannabis use during pregnancy affect infant survival?
This study found that maternal cannabis use disorder was associated with a 40% higher risk of infant death in the first year, primarily from perinatal conditions and sudden unexpected infant death. However, the study cannot prove cannabis itself caused the deaths.
Were infants of cannabis users hospitalized more often?
No. After adjustment for other factors, there was no increased risk of infant hospitalizations or emergency department visits. The excess risk was specifically for infant mortality.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-04396APA
Bandoli, Gretchen; Delker, Erin; Schumacher, Benjamin T; Baer, Rebecca J; Kelly, Ann E; Chambers, Christina D. (2023). Prenatal cannabis use disorder and infant hospitalization and death in the first year of life.. Drug and alcohol dependence, 242, 109728. https://doi.org/10.1016/j.drugalcdep.2022.109728
MLA
Bandoli, Gretchen, et al. "Prenatal cannabis use disorder and infant hospitalization and death in the first year of life.." Drug and alcohol dependence, 2023. https://doi.org/10.1016/j.drugalcdep.2022.109728
RethinkTHC
RethinkTHC Research Database. "Prenatal cannabis use disorder and infant hospitalization an..." RTHC-04396. Retrieved from https://rethinkthc.com/research/bandoli-2023-prenatal-cannabis-use-disorder
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.