Intention to Breastfeed and Paternal Influence on Pregnant Mothers Exclusively Using Marijuana Compared with Other Substances.

Objective: To determine intention to breastfeed (ITBF) rates among mothers exclusively using marijuana (eMJ) compared with electronic cigarettes (eEcig), tobacco products (eTob), or multisubstances (MS), nonusers (NU), and the influence of paternal presence and paternal substance use. Study Design: Cross-sectional study of parental survey responses merged with electronic birth certificates. Accounting for clinical and social determinants of health, analyses of ITBF included (1) all mothers, (2) single mothers, and (3) mothers with fathers. Results: Among all mothers (n = 1,073), eMJ, eTob, and MS users had lower odds of ITBF compared with NU. Only eMJ users had lower odds of ITBF for those without paternal presence. However, in those mothers with a paternal presence, odds of ITBF were similar to NU for eMJ, eTob, and MS users when accounting for paternal factors, including paternal substance use. Conclusion: Women exclusively using MJ have lower ITBF compared with NU. However, paternal presence mitigated this effect, independent of parental MJ use. The presence of fathers may represent a unique predictor for increased ITBF in MJ using mothers.

Impact of paternal presence and parental social-demographic characteristics on birth outcomes.

OBJECTIVES: Maternal race, marital status, and social environment impact risk of preterm delivery and size for gestational age. Although some paternal characteristics such as age are associated with pregnancy outcomes, the influence of the paternal presence, race/ethnicity and adverse life events is not well known. The objective of the study was to assess birth outcomes in mothers with a paternal presence compared to those without during the post-partum period. The secondary aim was to determine whether paternal race is associated with birth outcomes. METHODS: This was a cross-sectional study using parental surveys linked with birth certificate data from 2016 to 2018. Adverse birth composite outcomes (ABCO) including small for gestational age (SGA), prematurity or neonatal intensive care unit admission (NICU) were assessed. RESULTS: A total of 695 parents were analyzed (239 single mothers and 228 mother-father pairs). Compared to mothers with a father present, mothers without a father present exhibited increased odds of ABCO, prematurity and NICU. Non-Hispanic Black fathers had increased odds of ABCO and NICU compared to Non-Hispanic Whites (NHW). Hispanic fathers had increased odds of NICU compared to NHW. CONCLUSIONS: Paternal absence in the post-partum period and paternal race were both independently associated with ABCO and NICU. Assessment of paternal presence and paternal race in clinical practice may help identify opportunities for additional support necessary to optimize birth outcomes.

Lifestyle characteristics of parental electronic cigarette and marijuana users: healthy or not?

Objective To assess lifestyle characteristics among parental electronic cigarette (e-cigarette), marijuana and tobacco users. Methods A total of 1214 parents (77% mothers and 23% fathers) were surveyed and categorized into five exposure groups: e-cigarette use only (1%), marijuana use only (3%), tobacco products only (10%), multi-exposed [11% (marijuana, e-cigarette and tobacco)], and non-users [75% (no e-cigarette, tobacco or marijuana)]. Results Similar to non-users, the e-cigarette group had no illicit drug use. Further, e-cigarette users were more likely, in adjusted models, to self-identify as non-smokers and exercise compared with tobacco and multi-exposed groups. Although marijuana users also had higher odds of self-identifying as non-smokers compared to tobacco and multi-exposed groups, they were more likely than non-users to drink alcohol. Conclusion E-cigarette and marijuana using parents were less likely to identify as smokers. E-cigarette users had healthier lifestyle characteristics than the other exposed groups. Clinicians should consider specifically screening for parental e-cigarette and marijuana use as assessing for only "smoking" may underrepresent first-and second-hand exposure. Additionally, clinicians should be aware that marijuana using parents are more likely to drink alcohol and should counsel accordingly.