Marijuana Use in Opioid Exposed Pregnancy Increases Risk of Preterm Birth

Background: The prevalence of opioid use disorder has increased across the United States, but the rural population of Appalachia has been disproportionately impacted. Concurrently, the slow, but steady progress in the legalization of marijuana may be affecting perception of marijuana use in pregnancy. However, marijuana use in pregnancy has been associated with adverse perinatal outcomes. Concomitant use of opioids and marijuana in pregnancy has not been evaluated. Objective: The primary aim of the study was to evaluate the association between confirmed marijuana use in late pregnancy and preterm birth in opioid-exposed pregnancies. Methodology: A retrospective chart review was conducted that included all births from July 2011 to June 2016 from 6 delivery hospitals in South-Central Appalachia. Out of 18,732 births, 2368 singleton pregnancies indicated opioid use and met remaining inclusion criteria, with 108 of these mothers testing positive for marijuana at delivery. Independent sample t-test and Chi-Square analyses compared marijuana and non-marijuana exposed groups on maternal and neonatal outcomes. Regression analyses controlled for confounding variables in predicting neonatal abstinence syndrome (NAS), NICU admission, preterm birth, small for gestational age, and low birth weight outcomes as shown in Table 1. Results: Neonates born to marijuana-positive women in opioid-exposed pregnancy were more likely to be born preterm, small for gestational age, have low birth weight, and be admitted to NICU. After statistically controlling for parity, marital status, tobacco and benzodiazepine use, preterm birth and low birth weight remained statistically significant with aOR of 2.35 (1.30–4.24) and 2.01 (1.18–3.44), respectively. Conclusions: Maternal use of marijuana in any opioid-exposed pregnancy may increase risk of preterm birth and low-birth weight infants. Prospective studies need to examine the dose and timing of marijuana and opioid use in pregnancy to better delineate perinatal effects. Nonetheless, pregnant women using opioids, including recommended medication assisted treatment for opioid use disorder, should be educated about the risks of concurrent marijuana use during pregnancy and may need to be counseled to abstain from marijuana use during pregnancy for an optimal outcome

BMI, Perceived Physical Ability, and School Engagement in Elementary School Children

Students, grades 3-5, completed instruments assessing perceived physical ability and school engagement. No significant relationships were found or differences noted for categories of BMI. The culture and focus of the school may explain this

Attitudes Towards Physical Activity Participation and School Engagement in Elementary School Children

Numerous benefits are associated with physical activity participation with recent evidence indicating this may transfer into the classroom environment. Purpose: The purpose of this study was to investigate the relationship between attitudes towards active or passive physical activity participation and classroom engagement in elementary school children. Methods: Students (n = 67) in grades 3-5 completed The Children’s Self-Perceptions of Adequacy in and Predilection for Physical Activity (CSAPPA) and The Elementary Student Engagement Instrument (SEI). Results: A statistically significant positive correlation (r = .31, P \u3c .05) was found between the CSAPPA and SEI indicating that students who prefer active participation in physical activity also report higher levels of engagement within the school environment. No statistical difference was noted between males and females or across grade levels. Conclusion: The results of this research support the benefits of physical activity participation within the school environment. The lack of statistical difference with regard to sex is also noteworthy in that research connecting physical activity and classroom engagement frequently indicates differences between males and females. This is possibly attributed to the inclusive culture established by the school which promotes and supports opportunities for all students. These findings are particularly relevant in light of current trends to reduce time spent in physical education, free play, and other physical activity opportunities within the school da

Perceived Physical Ability and Self-Perception of Adequacy and Enjoyment for Physical Activity in Elementary Students

How children perceive their physical ability is important in understanding their reported adequacy, preferences, and predilection of physical activity. This relationship is useful in identifying lifelong physical activity behaviors. Purpose: The relationship between perceived physical ability and classroom engagement was investigated in elementary school children. Methods: Students (n = 120) in grades K5 completed the Perceived Physical Ability Scale (PPAS) and the Children’s Self-Perceptions of Adequacy and Predilection for Physical Activity (CSAPPA). Results: A statistically strong significant positive correlation (r = .49, P \u3c .01) was found between the PPAS and CSAPPA indicating that students with higher perceived physical ability also reported higher scores on the CSAPPA. The high CSAPPA scores are indicative of students having a higher likelihood of choosing physical activity over a non-active option. No significant differences were noted between males and females or across grade levels. Conclusions: Based on these results students who have a greater perception of their physical ability also report being more likely to select a physically active option when given the choice. The findings of this study are noteworthy as previous studies have shown that differences between male and female students may exist with similar measures. These results may be indicative of the environment that has been created at the study site. The study site promotes a culture centered on respect, care, and a growth mindset within its student body. Future research comparing student to teacher ratio, cohesive student groups, and school schedules should be conducted to compare students’ PPAS and CSAPPA results. Programs designed to enhance perceived physical ability and enjoyment of physical activity are needed to promote lifetime physical activity habits