{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T19:05:24Z","timestamp":1784919924885,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T00:00:00Z","timestamp":1749168000000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","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":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We evaluated associations between prenatal cannabis use and major structural birth defects of the child.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This population\u2010based retrospective cohort study comprised singleton births (January 2011\u2013July 2020) universally screened for substance use at entrance to prenatal care. Prenatal cannabis use was defined as self\u2010reported use or a positive toxicology test during pregnancy. Electronic health record and birth certificate data were used to identify 38 specific major structural birth defects within 8 organ systems (i.e., central nervous, eye, ear, cardiac, orofacial\/respiratory, gastrointestinal, genitourinary\/renal, and musculoskeletal). Modified Poisson regression models were conducted adjusting for propensity scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 363,952 infants, 22,494(6.2%) were exposed to maternal prenatal cannabis use, and 6094 infants (2.17%) had a major structural birth defect. Maternal prenatal cannabis use was associated with gastroschisis in the unadjusted (RR\u2009=\u20092.00, 95% CI: 1.25\u20133.19) and other non\u2010cannabis prenatal substance use (aRR\u2009=\u20091.68; 95% CI: 1.04\u20132.71) adjusted models, but not in the models adjusted for maternal age or the propensity score. Maternal prenatal cannabis use was associated with omphalocele in the unadjusted model (RR\u2009=\u20093.04; 95% CI: 1.42\u20136.48), maternal age\u2010adjusted model (aRR\u2009=\u20093.54; 95% CI: 1.68\u20137.48), other prenatal substance use\u2010adjusted model (aRR\u2009=\u20093.31; 95% CI: 1.50\u20137.31), and propensity score adjusted model (aRR: 2.92, 95% CI: 1.26\u20136.77). Cases of gastroschisis and omphalocele were rare: <jats:italic>n<\/jats:italic>\u2009=\u2009172 (0.05%) and <jats:italic>n<\/jats:italic>\u2009=\u200948 (0.01%), respectively. No associations emerged between maternal prenatal cannabis use and any other birth defects. Findings were replicated when cannabis was defined by toxicology testing only.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maternal prenatal cannabis use was associated with an increased risk for gastroschisis and omphalocele. Clinicians should provide counseling in a supportive manner to pregnant individuals about the potential harms associated with prenatal cannabis use.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2492","type":"journal-article","created":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T22:47:16Z","timestamp":1749250036000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Maternal Prenatal Cannabis Use and Major Structural Birth Defects"],"prefix":"10.1002","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8748-0614","authenticated-orcid":false,"given":"Lyndsay A.","family":"Avalos","sequence":"first","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara R.","family":"Adams","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey E.","family":"Alexeeff","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina R.","family":"Oberman","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique B.","family":"Does","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin R.","family":"Steuerle","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Santa Rosa Medical Center  Santa Rosa California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah R.","family":"Ansley","sequence":"additional","affiliation":[{"name":"Regional Offices Kaiser Permanente Northern California  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carley L.","family":"Castellanos","sequence":"additional","affiliation":[{"name":"Regional Offices Kaiser Permanente Northern California  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisa A.","family":"Padon","sequence":"additional","affiliation":[{"name":"Public Health Institute  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn D.","family":"Silver","sequence":"additional","affiliation":[{"name":"Public Health Institute  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly C.","family":"Young\u2010Wolff","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"},{"name":"Department of Psychiatry and Behavioral Sciences University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.89.1.67"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/a\u20101911\u20103326"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0041\u2010008x(86)90215\u20102"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ntt.2018.06.001"},{"issue":"1","key":"e_1_2_10_7_1","first-page":"22","article-title":"Critical Periods for Prenatal Alcohol Exposure: Evidence From Animal and Human Studies","volume":"18","author":"Coles C.","year":"1994","journal-title":"Alcohol Health and Research World"},{"key":"e_1_2_10_8_1","unstructured":"California Perinatal Quality Care Collaborative.2024. 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