The relationship between maternal cannabis use disorder diagnosis and the development of retinopathy of prematurity
| Journal | Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus |
| Study Type | Cohort |
| Population | Human participants |
This large retrospective cohort study addresses a critical gap in our understanding of maternal cannabis use effects on neonatal outcomes, specifically examining retinopathy of prematurity in high-risk preterm infants. Given increasing cannabis use during pregnancy, clinicians need evidence-based data to counsel patients about potential risks to infant eye development.
This retrospective cohort study analyzed 31,110 preterm infants (22-31 weeks gestation or <1500g birth weight) using the UC San Diego SOMI database, comparing ROP incidence between infants born to mothers with versus without cannabis use disorder diagnosis. The study found similar ROP rates: 32.1% in the CUD group (997 infants) versus 33.3% in the non-CUD group (30,113 infants). After adjusting for maternal covariates, no significant association was found between maternal CUD and infant ROP development. This represents one of the largest studies examining this specific maternal cannabis-neonatal outcome relationship.
“While reassuring that we don’t see increased ROP risk with maternal cannabis use disorder, I remain cautious about drawing broad conclusions given this relies on diagnostic coding rather than direct cannabis exposure measurement. The study design cannot capture dosing, timing, or product-specific factors that may be clinically relevant.”
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FAQ
Does maternal cannabis use disorder increase the risk of retinopathy of prematurity in preterm infants?
No, this large retrospective cohort study found no significant difference in ROP incidence between infants born to mothers with cannabis use disorder (32.1%) versus those without (33.3%). After adjusting for maternal demographic and clinical factors, maternal cannabis use disorder was not associated with increased risk of developing ROP in preterm infants.
What population was studied to determine the relationship between maternal cannabis use and ROP?
The study included infants born between 22 and less than 31 weeks’ gestation and/or with birth weight less than 1500g who survived to appropriate age for ROP screening. The cohort comprised 997 infants born to mothers with cannabis use disorder and 30,113 infants born to mothers without cannabis use disorder from the UC San Diego population-based database.
How was cannabis use disorder and ROP diagnosis determined in this study?
Both maternal cannabis use disorder during pregnancy and infant ROP were identified using International Classification of Diseases (ICD) diagnostic codes from hospital discharge records. This methodology relied on documented clinical diagnoses rather than self-reported cannabis use or screening results.
Should clinicians change ROP screening protocols for infants born to mothers with cannabis use disorder?
No, current evidence does not support modified ROP screening protocols based on maternal cannabis use disorder alone. Standard ROP screening guidelines based on gestational age and birth weight should continue to be followed regardless of maternal cannabis use disorder status.
What are the clinical implications of these findings for counseling pregnant patients who use cannabis?
While this study suggests maternal cannabis use disorder does not increase ROP risk, it does not indicate cannabis use during pregnancy is safe. Clinicians should continue evidence-based counseling about other established risks of prenatal cannabis exposure while noting that ROP risk does not appear to be elevated based on this research.
