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Pot Smoking in Pregnancy Tied to Stillbirth Risk

Finding may gain significance as legalization spreads across U.S., study author says
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The more a woman smokes, the higher the risk, Reddy said. For women, Reddy has a simple message: "Don't smoke. If you smoke, stop. You should not use marijuana during pregnancy."

Dr. Jill Rabin, chief of ambulatory care, obstetrics and gynecology at the Long Island Jewish Medical Center in New Hyde Park, N.Y., echoed Reddy's comments.

"We don't want our patients, either before they become pregnant or during pregnancy, to either smoke or use anything that is not medically necessary, like marijuana or even prescription drugs," said Rabin.

For the study, Varner's team analyzed 663 stillbirths that occurred between March 2006 and September 2008. They compared these with about 1,900 live births. For their analysis, they tested umbilical cord blood and blood from mothers for a variety of illegal drugs.

In addition, they asked the mothers about their tobacco and drug use, and looked for signs of tobacco use in mothers' blood samples.

The investigators found that a positive test result for use of an illicit drug was tied to a nearly doubling of risk for stillbirth. The most common drug found was marijuana, which was associated with a 2.8-fold increase for stillbirth.

Cigarette smoking was also associated with an increased risk of stillbirth, as was being exposed to secondhand smoke, the researchers found.

Yet, how strong the association is between all these different drugs and stillbirth isn't easy to pin down, another expert said.

"In pregnancy it's difficult to determine the exact cause of things, but there is clearly some connection there," said Dr. Ryan Walter, an obstetrician and gynecologist at Scott & White Healthcare in College Station, Texas.

Although all the evidence isn't in, Walter also advises women not to smoke, use drugs or drink when planning to become pregnant or when expecting.

The same is true for secondhand smoke, he said: "It's probably best not to be around it, but if you are married to a partner who smokes or you're in a family of smokers, it's going to be difficult to manage."

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