Cocaine and Opioid Use in Pregnancy Linked to Worse Newborn Outcomes Than Cannabis Alone
Pregnant women using cocaine and/or opioids had nearly 4 times higher odds of adverse newborn outcomes compared to those using only cannabis.
Quick Facts
What This Study Found
Among 177 pregnant women followed for addiction, those using cocaine and/or opioids (with or without cannabis) had 3.88 times higher odds of adverse neonatal outcomes compared to cannabis-only users. Surprisingly, cocaine/opioid exposure was associated with lower odds of adverse obstetrical outcomes (OR=0.39). 81.2% of the exposed group used opioids and 39.9% used cocaine.
Key Numbers
177 pregnant women: 80 exposed (cocaine/opioids), 97 reference (cannabis-only). Adverse neonatal outcomes: ORconditional=3.88 (95% CI: 1.23-12.23). Adverse obstetrical outcomes: ORconditional=0.39 (95% CI: 0.17-0.88). 81.2% opioids, 39.9% cocaine in exposed group.
How They Did This
Observational study at the Addi-Vie perinatal consultation center, CHUV Lausanne, Switzerland. 80 women using cocaine/opioids (with or without cannabis) compared to 97 cannabis-only users. Inverse probability treatment weighting used for adjusted analysis.
Why This Research Matters
Using cannabis-only users as the reference group (instead of drug-free controls) provides a more clinically relevant comparison for addiction medicine, better controlling for confounders associated with polysubstance use.
The Bigger Picture
By using cannabis-only as the reference, this study implicitly positions cannabis as a less harmful substance during pregnancy compared to cocaine and opioids, though it does not assess cannabis versus no substance use.
What This Study Doesn't Tell Us
Small sample from a single center. Cannabis-only reference group is not the same as a drug-free control. Cannot distinguish effects of individual substances within the exposed group. The unexpected protective obstetrical finding may reflect more intensive monitoring of higher-risk patients.
Questions This Raises
- ?Why were obstetrical outcomes better in the cocaine/opioid group?
- ?Would outcomes differ if the reference group were substance-free women?
Trust & Context
- Key Stat:
- 3.88x higher odds of adverse neonatal outcomes with cocaine/opioids versus cannabis-only exposure in pregnancy
- Evidence Grade:
- Novel reference group approach with appropriate weighting, but small sample, single center, and inability to isolate individual substance effects limit conclusions.
- Study Age:
- 2025 publication.
- Original Title:
- Risk of adverse obstetrical and neonatal outcomes in women consuming recreational drugs during pregnancy.
- Published In:
- BMC pregnancy and childbirth, 25(1), 456 (2025)
- Authors:
- Kandhasamy, Sreemanjari(2), Lepigeon, Karine, Baggio, Stéphanie(4), Céline, Roulet, Ceulemans, Michael, Winterfeld, Ursula, Jenkinson, Stephen P, Francini, Katyuska, Maisonneuve, Emeline, Panchaud, Alice
- Database ID:
- RTHC-06789
Evidence Hierarchy
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-06789APA
Kandhasamy, Sreemanjari; Lepigeon, Karine; Baggio, Stéphanie; Céline, Roulet; Ceulemans, Michael; Winterfeld, Ursula; Jenkinson, Stephen P; Francini, Katyuska; Maisonneuve, Emeline; Panchaud, Alice. (2025). Risk of adverse obstetrical and neonatal outcomes in women consuming recreational drugs during pregnancy.. BMC pregnancy and childbirth, 25(1), 456. https://doi.org/10.1186/s12884-024-07062-1
MLA
Kandhasamy, Sreemanjari, et al. "Risk of adverse obstetrical and neonatal outcomes in women consuming recreational drugs during pregnancy.." BMC pregnancy and childbirth, 2025. https://doi.org/10.1186/s12884-024-07062-1
RethinkTHC
RethinkTHC Research Database. "Risk of adverse obstetrical and neonatal outcomes in women c..." RTHC-06789. Retrieved from https://rethinkthc.com/research/kandhasamy-2025-risk-of-adverse-obstetrical
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.