Higher perinatal risks linked to cannabis + nicotine use during pregnancy

The findings of a recent study indicated that combined maternal use of cannabis and nicotine during pregnancy is tied to an escalated risk of infant and neonatal death, as well as maternal and neonatal complications, compared to using either substance alone. As the use of cannabis and nicotine during pregnancy rises, it’s crucial to understand how combining these substances impacts perinatal outcomes. Issued in “JAMA Network Open”, the study investigated the compounded risks associated with simultaneous cannabis and nicotine use.

This retrospective, cohort study included over 3 million pregnant individuals and examined those with cannabis and/or nicotine use and assessed their perinatal outcomes. Out of 3,129,259 pregnancies, 23,007 involved cannabis use, 56,811 involved nicotine use, and 10,312 involved both. As opposed to nonusers, cannabis or nicotine use was linked to higher rates of preterm delivery,  infant and neonatal death, and infants small for gestational age. Risks were notably higher compared to those using either substance alone, as seen in Table 1 below.

Combined use of cannabis and nicotine during pregnancy significantly magnifies the risk of adverse outcomes, including higher rates of infant and neonatal death, as well as preterm births. These findings highlight the need for enhanced counselling and support for pregnant individuals on the risks of using these substances together.