Associations Between Prenatal Cannabis Exposure and Childhood Outcomes

Abstract

In light of increasing cannabis use among pregnant women, the US Surgeon General recently issued an advisory against the use of marijuana during pregnancy.OBJECTIVE To evaluate whether cannabis use during pregnancy is associated with adverse outcomes among offspring. DESIGN, SETTING, AND PARTICIPANTSIn this cross-sectional study, data were obtained from the baseline session of the ongoing longitudinal Adolescent Brain and Cognitive Development Study, which recruited 11 875 children aged 9 to 11 years, as well as a parent or caregiver, from 22 sites across the United States between June 1, 2016, and October 15, 2018. EXPOSURE Prenatal cannabis exposure prior to and after maternal knowledge of pregnancy.MAIN OUTCOMES AND MEASURES Symptoms of psychopathology in children (ie, psychotic-like experiences [PLEs] and internalizing, externalizing, attention, thought, and social problems), cognition, sleep, birth weight, gestational age at birth, body mass index, and brain structure (ie, total intracranial volume, white matter volume, and gray matter volume). Covariates included familial (eg, income and familial psychopathology), pregnancy (eg, prenatal exposure to alcohol and tobacco), and child (eg, substance use) variables. RESULTS Among 11 489 children (5997 boys [52.2%]; mean [SD] age, 9.9 [0.6] years) with nonmissing prenatal cannabis exposure data, 655 (5.7%) were exposed to cannabis prenatally. Relative to no exposure, cannabis exposure only before (413 [3.6%]) and after (242 [2.1%]) maternal knowledge of pregnancy were associated with greater offspring psychopathology characteristics (ie, PLEs and internalizing, externalizing, attention, thought and, social problems), sleep problems, and body mass index, as well as lower cognition and gray matter volume (all |β| > 0.02; all false discovery rate [FDR]-corrected P < .03). Only exposure after knowledge of pregnancy was associated with lower birth weight as well as total intracranial volume and white matter volumes relative to no exposure and exposure only before knowledge (all |β| > 0.02; all FDR-corrected P < .04). When including potentially confounding covariates, exposure after maternal knowledge of pregnancy remained associated with greater PLEs and externalizing, attention, thought, and social problems (all β > 0.02; FDR-corrected P < .02). Exposure only prior to maternal knowledge of pregnancy did not differ from no exposure on any outcomes when considering potentially confounding variables (all |β| < 0.02; FDR-corrected P > .70). CONCLUSIONS AND RELEVANCEThis study suggests that prenatal cannabis exposure and its correlated factors are associated with greater risk for psychopathology during middle childhood. Cannabis use during pregnancy should be discouraged.

Prenatal THC does not affect female mesolimbic dopaminergic system in preadolescent rats

“…Current-clamp recordings were made with electrodes filled with a solution containing the following (in mM): 144 KCl, 10 HEPES buffer, 3.45 BAPTA, 1 CaCl 2 , 2.5 Mg 2 ATP and 0.25 Mg 2 GTP, pH 7.2–7.4, 275–285 mOsm. As previously described 1,11 , this solution had no effect on the holding current of the dopamine cells. Current-clamp experiments were performed in the absence of any pharmacological blocker, that is, in regular ACSF.…”

“…Children with a parent who has a mental illness or substance use disorder have a higher risk of psychiatric problems themselves 4,5 . Critically, prenatal cannabis exposure (PCE) increases the risk for child psychopathology, ranging from affective symptoms to ADHD and psychotic-like experiences 6–11 . With recreational cannabis legalization and permissive sociocultural attitudes expanding worldwide, and the use of cannabis among pregnant women on a sharp rise 12–14 , concern increases over the long-term negative impact on next generation health (i.e., pediatric concern) 15–19 .…”

Prenatal Cannabinoid Exposure: Emerging Evidence of Physiological and Neuropsychiatric Abnormalities

“…Several systematic reviews and meta-analyses have indicated that cannabis use leads to FGR and postnatal neurodevelopmental outcomes, however they are confounded by sociodemographic factors and the fact that users often used other drugs (e.g., tobacco) ( 18 , 19 , 23 , 24 ). Indeed, more contemporary studies, some of which account for multiple factors, including in utero exposure to other drugs (tobacco, alcohol, benzodiazepine, and opioids), race, age, medical insurance, parity, and marital status, report that prenatal cannabis exposure alone is sufficiently predictive of LBW, PTD, and NICU admission ( 25 – 29 ).…”

“…Indeed, in a more recent retrospective observational cohort, a positive maternal Δ9–THC urine test at the first prenatal visit was associated with abnormal 12-month developmental scores in infants, as measured by the Ages and Stages: Social–Emotional Questionnaire (ASQ-SE) ( 27 ). Moreover, recent cross-sectional results from the ongoing Adolescent Brain Cognitive Development (ABCD) study, which recruited 11,875 children aged 9–11 years, found that prenatal exposure to cannabis was associated with deficits in attention, thought, and social problems after accounting for potentially confounding covariates ( 29 ). A moderate increase in the incidence of intellectual disability and learning disorders was also observed in a large retrospective analysis of children born between 2007 and 2012 in Ontario, Canada, though these results were not statistically robust ( 85 ).…”

Kaleidoscope

“…Paul et al explored the impact of prenatal cannabis exposure on childhood outcomes, taking data from the cross-sectional adolescent brain and cognitive development study of over 11 000 children aged 9-11 and their caregivers. 4 The issue is highly relevant given that US data show a greater than 100% rise in past-month cannabis use in women between 2002 and 2017, and there is evidence that Δ-9-tetrahydrocannabinol (THC) crosses the placenta, interfacing with the fetal endocannabinoid system that is involved in brain development. In the era of cannabis-derived medicinal products, there have also been debates on using cannabis for nausea in pregnancy.…”