Prenatal cannabis exposure predicts attention problems, without changes on fMRI in adolescents

Cioffredi, Leigh-Anne; Anderson, Hillary; Loso, Hannah; East, James E.; Nguyen, Philip; Garavan, Hugh; Potter, Alexandra

doi:10.1016/j.ntt.2022.107089

Cited by 18 publications

(8 citation statements)

References 60 publications

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“…However, at age 3.5 there was no difference in executive functioning between children with PCE and unexposed children ( 108 ). Likewise, during preadolescence (i.e., ages 9 and 10) in the ABCD cohort, cognitive deficits and changes in brain activity (fMRI) during tasks measuring response inhibition (i.e., the Stop Signal Task or SST), reward processing (i.e., the Monetary Incentive Delay task or MID), and working memory (i.e., the En-Back test) were not associated with PCE ( 109 ). However, PCE was significantly associated with higher attention problems (CBCL, ages 9–10) ( 109 ).…”

Section: Long-lasting Impact Of Pce On Behavior and Human Brain Devel...mentioning

confidence: 99%

“…Later, in middle childhood (i.e., age 6), PCE was associated with a higher level of hair cortisol concentrations relative to non-exposed children, suggestive of alterations in child HPA-axis function following in utero cannabis exposure ( 111 ). In the ABCD study, PCE was significantly associated with higher externalizing problems and higher total problem scores (CBCL) ( 109 ) during middle childhood (i.e., ages 9 and 10). In the GenR cohort, during both middle childhood and preadolescence (i.e., ages 7 through 10), PCE was associated with offspring externalizing problems ( 112 ).…”

Section: Long-lasting Impact Of Pce On Behavior and Human Brain Devel...mentioning

confidence: 99%

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Influence of prenatal cannabinoid exposure on early development and beyond

Mulligan

Hamre²

2023

Adv. Drug Alcohol Res.

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Public perception surrounding whether cannabis use is harmful during pregnancy often diverges greatly from the recommendations of doctors and healthcare providers. In contrast to the medical guidance of abstinence before, during, and after pregnancy, many women of reproductive age believe cannabis use during pregnancy is associated with little potential harm. Legalization and social cues support public perceptions that cannabis use during pregnancy is safe. Moreover, pregnant women may consider cannabis to be a safe alternative for treating pregnancy related ailments, including morning sickness. Compounding the problem is a lack of medical and federal guidance on safe, low, or high-risk levels of cannabis use. These issues mirror the continuing debate surrounding alcohol use and health, in particular, whether there are safe or lower risk levels of alcohol consumption during pregnancy. Clinical studies to date suffer from several limitations. First, most human studies are correlative in nature, meaning that causal associations cannot be made between in utero cannabis exposure and health and behavioral outcomes later in life. Due to obvious ethical constraints, it is not possible to randomly assign pregnant mothers to cannabis or other drug exposure conditions—a requirement needed to establish causality. In addition, clinical studies often lack quantitative information on maternal exposure (i.e., dose, frequency, and duration), include a small number of individuals, lack replication of outcome measures across cohorts, rely on self-report to establish maternal drug use, and suffer from unmeasured or residual confounding factors. Causal associations between maternal cannabis exposure and offspring outcomes are possible in preclinical cohorts but there is a large amount of heterogeneity across study designs and developmental differences between rodents and humans may limit translatability. In this review, we summarize research from human and preclinical models to provide insight into potential risks associated with prenatal cannabinoid exposure (PCE). Finally, we highlight gaps in knowledge likely to contribute to the growing divide between medical guidance and public attitudes regarding cannabis use during pregnancy.

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Section: Long-lasting Impact Of Pce On Behavior and Human Brain Devel...mentioning

confidence: 99%

Section: Long-lasting Impact Of Pce On Behavior and Human Brain Devel...mentioning

confidence: 99%

Influence of prenatal cannabinoid exposure on early development and beyond

Mulligan

Hamre²

2023

Adv. Drug Alcohol Res.

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“…To our knowledge, 18 epidemiologic reports have examined the association between prenatal exposure to cannabis and offspring behavior between 0–16 years of age [ 22 , 23 , 24 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ]. Most reports found evidence that prenatal exposure to cannabis was associated with greater presentation of externalizing behaviors [ 22 , 55 , 63 ], aggressive behaviors [ 52 , 63 , 64 ], attention problems [ 22 , 51 , 52 , 53 , 54 , 55 , 64 , 65 ], depressive symptoms [ 56 , 57 , 64 ], and other behavioral changes [ 55 , 62 , 64 ] in the offspring, while others reported no association between prenatal exposure to cannabis and offspring behavior [ 23 , 58 , 59 , 60 , 61 , 66 ]. Two reports suggested that cannabis-exposed offspring may exhibit improved sustained attention [ 24 , 60 ].…”

Section: Introductionmentioning

confidence: 99%

Associations between Prenatal and Postnatal Exposure to Cannabis with Cognition and Behavior at Age 5 Years: The Healthy Start Study

Moore

Salmons

Hoyt³

et al. 2023

IJERPH

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Background: Prenatal exposure to cannabis may influence childhood cognition and behavior, but the epidemiologic evidence is mixed. Even less is known about the potential impact of secondhand exposure to cannabis during early childhood. Objective: This study sought to assess whether prenatal and/or postnatal exposure to cannabis was associated with childhood cognition and behavior. Study design: This sub-study included a convenience sample of 81 mother–child pairs from a Colorado-based cohort. Seven common cannabinoids (including delta 9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD)) and their metabolites were measured in maternal urine collected mid-gestation and child urine collected at age 5 years. Prenatal and postnatal exposure to cannabis was dichotomized as exposed (detection of any cannabinoid) and not exposed. Generalized linear models examined the associations between prenatal or postnatal exposure to cannabis with the NIH Toolbox and Child Behavior Checklist T-scores at age 5 years. Results: In this study, 7% (n = 6) of the children had prenatal exposure to cannabis and 12% (n = 10) had postnatal exposure to cannabis, with two children experiencing this exposure at both time points. The most common cannabinoid detected in pregnancy was Δ9-THC, whereas the most common cannabinoid detected in childhood was CBD. Postnatal exposure to cannabis was associated with more aggressive behavior (β: 3.2; 95% CI: 0.5, 5.9), attention deficit/hyperactivity problems (β: 8.0; 95% CI: 2.2, 13.7), and oppositional/defiant behaviors (β: 3.2; 95% CI: 0.2, 6.3), as well as less cognitive flexibility (β: −15.6; 95% CI: −30.0, −1.2) and weaker receptive language (β: −9.7; 95% CI: −19.2, −0.3). By contrast, prenatal exposure to cannabis was associated with fewer internalizing behaviors (mean difference: −10.2; 95% CI: −20.3, −0.2) and fewer somatic complaints (mean difference: −5.2, 95% CI: −9.8, −0.6). Conclusions: Our study suggests that postnatal exposure to cannabis is associated with more behavioral and cognitive problems among 5-year-old children, independent of prenatal and postnatal exposure to tobacco. The potential risks of cannabis use (including smoking and vaping) during pregnancy and around young children should be more widely communicated to parents.

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“…Another study by Cioffredi et al . 110 looked at PME in the context of three fMRI tasks and CBCL scores from the ABCD® Study. Similar to our study, they identified adolescents with PME having greater attention, externalizing and total problems scores.…”

Section: Discussionmentioning

confidence: 99%

Impact of prenatal marijuana exposure on adolescent brain structural and functional connectivity and behavioural outcomes

Vishnubhotla,

Ahmad,

Zhao

et al. 2024

Brain Communications

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There has been an increase in the number of women using marijuana while pregnant. Previous studies have shown that children with prenatal marijuana exposure (PME) have developmental deficits in memory and decreased attentiveness. In this study we assess whether PME is associated with alterations in brain regional morphometry and functional and structural connectivity in adolescents. We downloaded behavioral scores and subject image files from the Adolescent Brain Cognitive DevelopmentSM (ABCD®) Study. 178 anatomical diffusion MRI files (88 PME, 90 age and gender matched controls) and 152 resting state functional MRI (rs-fMRI) files (76 PME, 76 controls) were obtained. Behavioral metrics based on the parent-reported child behavioral checklist (CBCL) were also obtained for each subject. The association of PME with 17 subscales of the CBCL was calculated. We assessed differences in brain morphometry based on voxel-based and surface-based morphometry in adolescents with PME versus controls. We also evaluated differences in structural and functional connectivity in adolescents for region-to-region connectivity and graph theoretical modeling. Interactions of PME and graph networks were assessed for impact on behavioral scores. Multiple comparison correction was performed as appropriate. Adolescents with PME had greater abnormal or borderline CBCL scores in 9 out of 17 subscales. There were no significant differences in voxel or surface-based morphometry, structural connectivity, or functional connectivity between PME and controls. However, there were significant differences in PME-graph network interactions with respect to behavioral scores. There were 3 structural PME-graph network interactions and 7 functional PME-graph network interactions that were significantly associated with behavioral scores. While this study was not able to confirm anatomical or functional differences between PME and unexposed pre-adolescent children, there were PME- brain structural and functional graph network interactions that were significantly associated with behavioral scores. This suggests that altered brain networks may underlie behavioral outcomes in adolescents with PME. More work needs to be conducted to better understand the prognostic value of brain structural and functional network measures in PME.

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Prenatal cannabis exposure predicts attention problems, without changes on fMRI in adolescents

Cited by 18 publications

References 60 publications

Influence of prenatal cannabinoid exposure on early development and beyond

Influence of prenatal cannabinoid exposure on early development and beyond

Associations between Prenatal and Postnatal Exposure to Cannabis with Cognition and Behavior at Age 5 Years: The Healthy Start Study

Impact of prenatal marijuana exposure on adolescent brain structural and functional connectivity and behavioural outcomes

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