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May 08, 2022
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Tobacco, marijuana use may play a role in gestational weight gain

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SAN DIEGO — Tobacco and marijuana use may impact gestational weight gain, according to findings presented at the ACOG Annual Clinical & Scientific Meeting.

“Marijuana use in pregnancy leads to an increase in excessive gestational weight gain, as does former tobacco use,” Elizabeth Mirsky, MD, a third-year resident at the University of Tennessee Graduate School of Medicine, told Healio. “This suggests the importance of antenatal counseling on recommended weight gain in pregnancy, especially for patients with tobacco or marijuana use.”

Smoking cigarette and ashtray
Tobacco and marijuana use may impact gestational weight gain. Source: Adobe Stock.

In a retrospective study, Mirsky and colleagues evaluated patients who delivered at a single academic institution between January 2019 and June 2021 for weight before pregnancy, BMI, gestational weight gain and tobacco or marijuana use. Using Institute of Medicine and ACOG recommendations, Mirksy and colleagues categorized gestational weight gain by 7,653 patients as adequate, inadequate or excessive. Patients with polysubstance use were excluded. The patients were aged 15 to 45 years and most were white, Mirsky said.

Overall, 52% of patients experienced excessive, 28% adequate and 19% inadequate gestational weight gain. Mirsky and colleagues reported that former tobacco users were more likely to have excessive gestational weight gain compared with nonsmokers or current users (61% vs. 51% vs. 51%; P < .001). Also, current tobacco users were more likely to have inadequate weight gain compared with nonusers or former users (24% vs. 19% vs. 15%; P < .001). The researchers reported that marijuana users were also more likely to have excessive gestational weight gain compared with nonusers (57% vs. 52%; P = .007). Marijuana use significantly predicted excessive weight gain, even when controlling for tobacco use (P < .035).

Elizabeth Mirsky, MD
Elizabeth Mirsky

“We were somewhat surprised by the fact that former tobacco use was associated with excessive gestational weight gain, as we know that current tobacco use is typically associated with inadequate weight gain,” Mirsky said.

Additional research is needed to fully understand the effects of tobacco and marijuana use on gestational weight gain and pregnancy outcomes, according to the researchers. However, Mirsky emphasized the importance of antenatal counseling on recommended gestation weight gain, particularly among women with substance use.