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Cannabis use might increase the risk of GDM by increasing appetite or promoting fat deposition and adipogenesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to assess the association between preconception cannabis use and GDM incidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed individual\u2010level data from eight prospective cohort studies. We identified the first, or index, pregnancy (lasting \u226520\u2009weeks of gestation with GDM status) after cannabis use. In analyses of pooled individual\u2010level data, we used logistic regression to estimate study\u2010type\u2010specific odds ratios (OR) and 95% confidence intervals (CI), adjusting for potential confounders using random effect meta\u2010analysis to combine study\u2010type\u2010specific ORs and 95% CIs. Stratified analyses assessed potential effect modification by preconception tobacco use and pre\u2010pregnancy body mass index (BMI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 17,880 participants with an index pregnancy, 1198 (6.7%) were diagnosed with GDM. Before the index pregnancy, 12.5% of participants used cannabis in the past year. Overall, there was no association between preconception cannabis use in the past year and GDM (OR 0.97, 95% CI 0.79, 1.18). Among participants who never used tobacco, however, those who used cannabis more than weekly had a higher risk of developing GDM than those who did not use cannabis in the past year (OR 2.65, 95% CI 1.15, 6.09). This association was not present among former or current tobacco users. Results were similar across all preconception BMI groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this pooled analysis of preconception cohort studies, preconception cannabis use was associated with a higher risk of developing GDM among individuals who never used tobacco but not among individuals who formerly or currently used tobacco. Future studies with more detailed measurements are needed to investigate the influence of preconception cannabis use on pregnancy complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.13008","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:34:06Z","timestamp":1695774846000},"page":"69-85","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The association between preconception cannabis use and gestational diabetes mellitus: The Preconception Period Analysis of Risks and Exposures Influencing health and Development (<scp>PrePARED<\/scp>) consortium"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2667-9026","authenticated-orcid":false,"given":"Ke","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Epidemiology Tulane School of Public Health and Tropical Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8635-9505","authenticated-orcid":false,"given":"Anne Marie","family":"Jukic","sequence":"additional","affiliation":[{"name":"Epidemiology Branch National Institute of Environmental Health Sciences  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gita D.","family":"Mishra","sequence":"additional","affiliation":[{"name":"School of Public Health University of Queensland  Herston Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0133-3176","authenticated-orcid":false,"given":"Sunni L.","family":"Mumford","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2138-3752","authenticated-orcid":false,"given":"Lauren A.","family":"Wise","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique F.","family":"Schisterman","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia H.","family":"Ley","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Tulane School of Public Health and Tropical Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany M.","family":"Charlton","sequence":"additional","affiliation":[{"name":"Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute  Boston Massachusetts USA"},{"name":"Department of Epidemiology Harvard T.H. 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