{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:14:45Z","timestamp":1772964885506,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T00:00:00Z","timestamp":1699574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008576","name":"Central Michigan University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008576","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>With recent changes in tobacco and marijuana use patterns, it becomes crucial to understand how the prenatal co\u2010use of these substances impacts birth outcomes. The goal of this study was to examine the risk of adverse birth outcomes among infants born to women who used tobacco and marijuana concurrently throughout pregnancy compared to infants of women who used tobacco alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study involved a retrospective chart review of pregnant women identified via self\u2010report or biochemical testing who used tobacco products alone (<jats:italic>N<\/jats:italic>\u2009=\u200971) or tobacco and marijuana simultaneously (<jats:italic>N<\/jats:italic>\u2009=\u2009127) at any point throughout pregnancy. Differences in birth outcomes between these groups, including APGAR (appearance, pulse, grimace, activity, and respiration) scores, respiratory distress, neonatal intensive care unit admission, intrauterine growth restriction, birth weight, birth length, head circumference, gestational age, and length of hospital stay, were analyzed using linear regression and odds ratio analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences in outcomes for infants of women who used tobacco and marijuana compared to infants of women who used tobacco alone during pregnancy. Rates of adverse birth outcomes were high among women who used tobacco compared to what would be expected in unexposed pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Tobacco and marijuana co\u2010use during pregnancy was not associated with an additional risk of adverse birth outcomes compared to tobacco use alone. Women should be educated on potential risks of marijuana, and especially, tobacco use during pregnancy. These results will inform clinical recommendations for pregnant women using tobacco and marijuana, aiming to decrease preventable adverse outcomes for patients and infants.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2272","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T09:00:27Z","timestamp":1699606827000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Birth outcomes following in utero co\u2010exposure to tobacco and marijuana"],"prefix":"10.1002","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0047-8106","authenticated-orcid":false,"given":"Madison L.","family":"Waddell","sequence":"first","affiliation":[{"name":"College of Medicine Central Michigan University  Mount Pleasant Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha A.","family":"Dickson","sequence":"additional","affiliation":[{"name":"College of Medicine Central Michigan University  Mount Pleasant Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phoebe A.","family":"Dodge","sequence":"additional","affiliation":[{"name":"College of Medicine Central Michigan University  Mount Pleasant Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haley E.","family":"Kopkau","sequence":"additional","affiliation":[{"name":"College of Medicine Central Michigan University  Mount Pleasant Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine N.","family":"Nadolski","sequence":"additional","affiliation":[{"name":"College of Medicine Central Michigan University  Mount Pleasant Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Zablocki","sequence":"additional","affiliation":[{"name":"College of Medicine Central Michigan University  Mount Pleasant Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaya M.","family":"Forrestal","sequence":"additional","affiliation":[{"name":"College of Medicine Central Michigan University  Mount Pleasant Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth A.","family":"Bailey","sequence":"additional","affiliation":[{"name":"College of Medicine Central Michigan University  Mount Pleasant Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2013.01.036"},{"issue":"4","key":"e_1_2_9_3_1","first-page":"205","article-title":"Marijuana use during pregnancy and lactation","volume":"130","author":"American College of Obstetricians and Gynecologists (ACOG)","year":"2017","journal-title":"ACOG Committee Opinion"},{"issue":"5","key":"e_1_2_9_4_1","first-page":"221","article-title":"Tobacco and nicotine cessation during pregnancy","volume":"135","author":"American College of Obstetricians and Gynecologists (ACOG)","year":"2020","journal-title":"ACOG Committee Opinion"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-020-0643-z"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.4172\/2155-6105.1000135"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2016.02.022"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.05.044"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ntt.2018.06.001"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.03.025"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001649"},{"issue":"1","key":"e_1_2_9_12_1","first-page":"1","article-title":"Smoking prevalence and cessation before and during pregnancy: Data from the birth certificate, 2014","volume":"65","author":"Curtin S. 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