Cannabis use after pregnancy shows no link to high blood pressure

Cannabis Exposure After Pregnancy and Development of Hypertension in the nuMoM2b Heart Health Study.

O&G open • • Moderately Relevant
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AI Summary

This study examined whether cannabis use after pregnancy was associated with the development of high blood pressure in women. Researchers followed 4,079 nulliparous women (those who had their first pregnancy) from pregnancy through a follow-up visit 2-7 years later, looking for signs of incident hypertension. Of these women, 10% tested positive for THC metabolites in their urine at the follow-up visit, indicating recent cannabis exposure. The study used urine testing to detect THC-COOH, the primary metabolite of cannabis, to objectively measure exposure rather than relying solely on self-reporting.

The key finding was reassuring: cannabis exposure was not associated with increased hypertension risk after adjusting for other factors like nicotine exposure and pregnancy-related health factors. Only 5.3% of the study population developed hypertension during the follow-up period, and this rate was similar between cannabis users and non-users. The researchers carefully controlled for confounding variables, including active nicotine exposure measured through both biological markers (serum cotinine) and self-report, ensuring the results weren't influenced by other substance use patterns.

This research provides important evidence that postpartum cannabis use alone was not a significant risk factor for hypertension in this well-characterized population of women. However, it's important to note this was a secondary analysis of observational data, and the findings apply specifically to women in the postpartum period rather than the general population. The study contributes to our understanding of cannabis safety in the postpartum period, an important consideration for women navigating cannabis use after childbirth.

📄 Original Abstract

To evaluate whether cannabis exposure after a first pregnancy was associated with incident hypertension 2-7 years after that pregnancy. This was a secondary, cross-sectional analysis of the nuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers to Be) Heart Health Study. Nulliparous participants were followed up from the first trimester to an in-person study visit 2-7 years after their pregnancy. The primary exposure was cannabis use after pregnancy, which was detected by having urine positive for THC-COOH (11-nor-9-carboxy-delta-9-tetrahydrocannabinol) metabolite (cutoff 15 ng/mL or higher) at the study visit at 2-7 years. The primary outcome of this analysis was incident hypertension (systolic blood pressure 140 mm Hg or higher or diastolic blood pressure 90 mm Hg or higher) or use of an antihypertensive agent at the time of the follow-up visit at 2-7 years. A multivariable logistic regression model was fitted and adjusted for covariates that were selected a priori, including nicotine exposure assessed at the follow-up visit (measured through serum cotinine levels or self-report), to assess whether cannabis exposure was associated with the occurrence of incident hypertension. Of 4,079 participants, 216 (5.3%) developed hypertension by the study visit at 2-7 years. Neither exposure to cannabis in 406 participants (10.0%) (adjusted odds ratio [AOR] 1.05, 95% CI, 0.63-1.76) nor active nicotine exposure (AOR 1.03, 95% CI, 0.66-1.63) was associated with incident hypertension in multivariable modeling. In this population of nulliparous women, cannabis exposure 2-7 years after pregnancy was not associated with incident hypertension after controlling for nicotine exposure and known risk factors measured during the pregnancy.

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