Pregnancy

Prenatal cannabis exposure is associated with slightly increased ADHD risk (OR 1,13) and increased cannabis use in offspring (OR 1,20), but not with increased risk for ASD, psychotic symptoms, anxiety disorders or depression.

Systematic review and meta-analysis of k=17 observational studies (n=534.445) on prenatal cannabis exposure and neuropsychiatric outcomes in offspring; for ADHD pooled OR=1.13 (95% CI 1.01–1.26) after confounder adjustment. Statistically significant but weak association between in-utero cannabis exposure and increased ADHD risk.

Prenatal cannabis exposure is associated with increased risk of ADHD symptoms and autism spectrum disorder in offspring.

Systematic review and meta-analysis on prenatal cannabis exposure and neurodevelopmental disorders; k=14 studies (10 on ADHD, 4 on ASD), n=203.783 participants. Prenatal cannabis exposure associated with increased risk of ADHD symptoms (β=0,39; 95% CI 0,20–0,58, I²=66,85%, p=0,001) and diagnosed ADHD (RR=1,13; 95% CI 1,01–1,26) as well as ASD (RR=1,30; 95% CI 1,03–1,64, I²=45,5%, p=0,14) in offspring.

Prenatal cannabis exposure significantly increases the risk of adverse neonatal outcomes, including low birth weight, preterm birth and NICU admission.

SR+MA of k=16 studies (n=59.138) on neonatal outcomes with cannabis use in pregnancy vs. no exposure: significantly increased risk of birth weight <2.500 g (RR=2,06; 95%-CI 1,25–3,42; p=0,005), small for gestational age (RR=1,61; 95%-CI 1,44–1,79; p<0,001), preterm birth <37 weeks of gestation (RR=1,28; 95%-CI 1,16–1,42; p<0,001) and NICU admission (RR=1,38; 95%-CI 1,18–1,62; p<0,001); mean birth weight reduced by -112,3 g (95%-CI -167,19 to -57,41; p<0,001).

Prenatal cannabis exposure may be associated with affective symptoms and ADHD, but has not yet been comprehensively researched.

Systematic review on prenatal cannabis exposure. Prenatal cannabis exposure possibly associated with affective symptoms and ADHD in offspring. Number of included studies not specified in the abstract; no numerical effect sizes reported.

Prenatal cannabis exposure after knowledge of the pregnancy is associated with increased childhood psychopathology after covariate adjustment; exposure before knowledge shows no independent effects after adjustment.

ABCD study (n=11.489 children 9–11 years, 22 US sites); prenatal cannabis exposure after knowledge of pregnancy associated with significantly increased childhood psychopathology (PLEs, externalizing/internalizing/attention/social behavior), sleep problems, increased BMI, lower cognition and reduced brain volume (all FDR-corrected p<0,04; all |β|>0,02). Exposure exclusively before knowledge of pregnancy after covariate control: no significant effect (FDR-corrected p>0,70).

Periconceptional maternal cannabis use was not significantly associated with an increased ASD risk in the child.

Periconceptional cannabis use (3 months preconceptionally until delivery) in n=4.254 children (ASD n=1.428, DD n=1.198, POP controls n=1.628): reported usage rates 5,2 % (ASD), 3,2 % (DD), 4,4 % (POP). Adjusted odds for periconceptional cannabis use did not differ significantly between ASD cases and DD or POP controls (p>0,05) — no significantly increased ASD risk demonstrable.

Prenatal cannabis exposure and early age of onset increase the risk of psychotic symptoms, whereby the mediation pathway via EAOM was not significant.

Prospective cohort study (n=596): prenatal cannabis exposure (PME) — assessed from the 4th month of pregnancy — significantly predicted increased rates of psychotic symptoms in offspring at age 22 (total effect p<0,05). Direct effect of PME marginally significant (p=0,06) after adjustment for EAOM and other prenatal substance exposures.

Prenatal cannabis exposure in the 1st and 3rd trimester significantly increases the level of depressive symptoms in 10-year-old children.

Longitudinal cohort study (n=633 mother-child pairs); prenatal cannabis exposure (PME) in trimester 1 and 3 was significantly associated with increased depressive symptoms in children at 10 years of age (CDI total score, p<0.05 after controlling for covariates including education, tobacco and IQ). Trimester 2 exposure showed no significant effect.