ABCD Study Results: Is There a Link Between Prenatal Cannabis Use and Adverse Psychopathological Effects in Children?
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
Ongoing longitudinal Adolescent Brain and Cognitive Development (ABCD) Study
Children aged 9 to 11
Their parents/caregivers from 22 sites across the U.S.
Prenatal cannabis exposure prior to maternal knowledge of pregnancy
Cannabis exposure after maternal knowledge of pregnancy
Psychopathology in children definition: Psychotic-like experiences (PLEs) and/or internalizing, externalizing, attention, thought, and social problems
Familial (e.g. income and familial psychopathology)
Pregnancy-related (e.g. prenatal exposure to alcohol and tobacco)
Child (e.g. substance use)
Symptoms of psychopathology in children
Gestational age at birth
Brain structure (total intracranial volume, white matter volume, and gray matter volume)
11,489 children included
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
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)
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
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