The Impact of Opioid and Cannabis Exposure on Fetal Growth

Inclusion Criteria:

1. Participant who, in the opinion of the investigator, can and will comply with therequirements of the protocol.

2. Participant has given written consent after study has been explained according tolocal regulatory requirements and before any study specific procedures.

3. Age ≥16 years at the time of consent.

4. Singleton pregnancy.

5. Live fetus (documented positive fetal heart beat prior to recruitment)

6. ≥18 0/7 weeks of gestation and documented anatomy ultrasound at the time of consent.

7. No known significant fetal genetic abnormalities (based on genetic testing, ifperformed).

8. No significant congenital malformations (such as abnormal fetal morphology, abnormalamniotic fluid levels, significant abnormalities in placenta or umbilical cord), asassessed by fetal anomaly ultrasound scan (also known as a level 2 ultrasound orfetal morphology assessment) conducted at or beyond 18 0/7 weeks of gestation.

9. Willing to provide cord blood.

10. Willing to provide placenta.

11. Willing to provide urine sample for drug testing.

12. Plan to reside in the study area at least until delivery.

Exclusion Criteria:

1. Sustained use of substances other than opioids and cannabis, includingmethamphetamines, benzodiazepines, alcohol, and cocaine. This is defined as any useafter the patient is aware that they are pregnant OR as per the discretion of theinvestigator.

2. Acute or chronic clinically significant abnormality or poorly controlledpre-existent co-morbidities or any other clinical conditions, as determined byphysical examination or standard of care laboratory tests, that, in the opinion ofthe investigator, might confound study results.

3. Known abnormal placentation including accrete, increta and percreta.

4. Any conditions that, in the Investigator's judgement, may interfere withparticipant's ability to comply with study procedures or receipt of prenatal care,such as behavioural or cognitive impairment or neuropsychiatric illness.

5. Concurrently participating in another clinical study, at any time during the studyperiod, in which the participant has been or will be exposed to an investigationalor a non-investigational vaccine/product.

6. COVID-19 infection being diagnosed within 14 days of consent - recruitment may bedelayed until required isolation period is over.