# Maternal Marijuana Use and Adverse Perinatal Outcomes

> **NIH NIH R01** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2020 · $675,785

## Abstract

Project Summary
Marijuana is the most commonly used drug during pregnancy with an estimated use prevalence of 7%, and
reaching as high as 25% in high risk groups. Marijuana components and metabolites cross the placenta and
may impact maternal and neonatal outcomes. Recently, the National Academy of Sciences found substantial
evidence linking prenatal marijuana use to lower birth weight and insufficient evidence to evaluate other
pregnancy outcomes. These findings highlight a critical knowledge gap. With increasing legalization of
marijuana in the United States, higher quality data about the risks of marijuana use during pregnancy are
desperately needed.
Prior studies are limited both by reliance on self-report rather than biologic sampling, and lack of adjustment for
important confounders. The result is ongoing uncertainty regarding the effect of marijuana use on perinatal
outcomes. The proposed observational study uses existing data and biospecimens from the nationwide
NICHD-sponsored Monitoring Mothers-to-Be Network (nuMOM2b). We hypothesize that marijuana use during
pregnancy will be associated with an increase in adverse perinatal outcomes independent of tobacco, other
drug use, and sociodemographic factors. Our specific aims are to: (1) Determine if exposure to marijuana is
associated with adverse perinatal outcomes. We will use existing data and banked specimens from 9,260
nulliparous women enrolled in nuMoM2b to ascertain marijuana use by both self-report and serial biological
sampling. We will assay stored urine samples from throughout pregnancy for biomarkers of marijuana
exposure, cotinine and other drugs. Our primary outcome is a composite of adverse outcomes reflecting
placental insufficiency: fetal growth restriction, medically-indicated preterm birth, stillbirth and hypertensive
disorders including preeclampsia and gestational hypertension. (2) Evaluate whether there is a critical window
of exposure or a threshold “dose” of exposure associated with adverse perinatal outcomes. We will use
advanced statistical modeling to clarify the effects of marijuana exposure on each component of the outcome,
and evaluate for critical windows of exposure. We will separately examine associations between our outcomes
and four quantified biomarkers of marijuana exposure, using a novel umbilical cord assay. (3) Evaluate the
agreement between different measures of prenatal marijuana use including umbilical cord assay, serial urine
assays and maternal self-report.
As marijuana legalization expands, rigorous observational studies such as this are urgently needed to
understand the impact of perinatal marijuana use. These findings could immediately be used in clinical practice
to counsel women regarding the anticipated effects of prenatal marijuana use. Together these aims will answer
key questions regarding marijuana exposure and perinatal outcomes using highly leveraged existing data and
biospecimens, thereby overcoming limitations that have previously h...

## Key facts

- **NIH application ID:** 10052065
- **Project number:** 1R01DA049832-01A1
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** Torri D Metz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $675,785
- **Award type:** 1
- **Project period:** 2020-09-30 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10052065

## Citation

> US National Institutes of Health, RePORTER application 10052065, Maternal Marijuana Use and Adverse Perinatal Outcomes (1R01DA049832-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10052065. Licensed CC0.

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