(624) Maternal Cannabis Exposure and Sleep Quality

Objective:
To investigate the relationship between maternal cannabis exposure in pregnancy and measures of sleep quality.

Study Design:
This was a secondary analysis of Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (NuMoM2b), a multi-center prospective observational cohort study of patients enrolled from 2010 to 2013. We included participants who completed the WHI (Women’s Health Initiative Insomnia Rating Scale) and had a urine specimen available from the first study visit (6w0d-13w6d). The exposure was cannabis use in early pregnancy, measured by 11-nor-9-carboxy-tetrahydrocannabinol (THC-COOH) detected by liquid chromatography mass spectrometry urine assay (detected if ≥15 ng/mL). The primary outcome was clinically significant insomnia, defined as a WHI score greater than or equal to 9. The secondary outcome, excessive daytime sleepiness, was defined as an ESS score (Epworth Sleepiness Scale) greater than or equal to 11. Primary and secondary outcomes were summarized between groups with differences tested using chi-square analyses. Adjusted odds ratios (aOR) for each outcome with THC exposure (versus without) were reported from multivariable logistic regression models.

Results:
Of 8163 individuals included for analysis, 482 (5.9%) had cannabis exposure. Cannabis exposure was significantly associated with age younger than 30, obesity, not having daytime employment, low social support, a positive depression screen, moderate to high perceived stress or anxiety, and cotinine from urine toxicology (Table 1). In multivariable modeling, there was no association between cannabis exposure and clinically significant insomnia (50.4 vs 41.0%; aOR 1.12 95% CI 0.91-1.37, Table 2) or excessive daytime sleepiness (26.3 vs 24.3%; aOR 0.94 95% CI 0.75-1.18, Table 2).

Conclusion:

Maternal cannabis exposure in early pregnancy was not associated with any standardized measures of sleep quality. Previously observed adverse pregnancy outcomes associated with maternal cannabis are likely mediated by mechanisms other than poor sleep quality.