BACKGROUND AND PURPOSE:

• Prenatal cannabis use has increased by approximately 100% from 2002 to 2017
  • Few studies have investigated possible associations between maternal cannabis use in pregnancy and adverse neonatal outcomes
• Paul et al. (JAMA Psychiatry, 2020) assessed whether cannabis use during pregnancy is associated with adverse outcomes among offspring

METHODS:

• Cross-sectional study
• Data source
  • Ongoing longitudinal Adolescent Brain and Cognitive Development (ABCD) Study
• Participants
  • Children aged 9 to 11
  • Their parents/caregivers from 22 sites across the U.S.
• Exposure
  • Prenatal cannabis exposure prior to maternal knowledge of pregnancy
  • Cannabis exposure after maternal knowledge of pregnancy
• Study design
  • Psychopathology in children definition: Psychotic-like experiences (PLEs) and/or internalizing, externalizing, attention, thought, and social problems
  • Covariates included
    • Familial (e.g. income and familial psychopathology)
    • Pregnancy-related (e.g. prenatal exposure to alcohol and tobacco)
    • Child (e.g. substance use)
• Primary outcome
  • Symptoms of psychopathology in children
  • Cognition
  • Sleep
  • Birth weight
  • Gestational age at birth
  • BMI
  • Brain structure (total intracranial volume, white matter volume, and gray matter volume)

RESULTS:

• 11,489 children included
  • 52.2% boys
  • Mean (SD) age: 9.9 (0.6) years
• Prenatal cannabis exposure: 5.7% (655 children)
• Compared to no exposure, cannabis exposure both before and after maternal knowledge of pregnancy was associated with
  • Greater offspring psychopathology characteristics
  • More sleep problems
  • Higher BMI
  • Lower cognition
  • Lower grey matter volume (P<0.03)
• Compared to both no exposure and exposure only before maternal knowledge of pregnancy, exposure after maternal knowledge of pregnancy was associated with
  • Lower birth weight
  • Lower total intracranial volume
  • Lower white matter volume (P<0.04)
  • When potential confounding covariates were included, exposure after maternal knowledge of pregnancy was still associated with greater PLEs and externalizing, attention, thought, and social problems (P<0.04)
• When considering potential confounding variables, there were no significant differences in any outcomes between exposure only prior to maternal knowledge of pregnancy and no exposure (P>0.70)

CONCLUSION:

• Prenatal cannabis use is associated with a greater risk for psychopathology during middle childhood
  • This increased risk does not exist when maternal cannabis use was restricted to the time prior to maternal knowledge of pregnancy
• The authors conclude that

…associations were robust to the inclusion of potentially confounding variables increases the plausibility that prenatal cannabis exposure may be independently associated with psychopathology risk in children

In contrast to increasingly permissive attitudes surrounding cannabis use among pregnant mothers and suggestions by dispensaries to use cannabis to combat pregnancy-related nausea, our findings align with recent recommendations by the US Surgeon General regarding the potential association of in utero cannabis exposure with outcomes in children

Learn More – Primary Sources:

Associations Between Prenatal Cannabis Exposure and Childhood Outcomes: Results From the ABCD Study

Related ObG Topics:

Does Cannabis Use During Pregnancy Increase Risk of Preterm Birth?

ACOG Recommendations on Marijuana Use During Pregnancy and Lactation

Does Daily Marijuana Use in Pregnancy Impair Fetal Growth?

Does Socioeconomic Status Affect Risk of Adverse Birth Outcomes?