Prenatal Cannabis Exposure and Childhood Outcomes: Results from the ABCD Study®

• In Event: Poster Session 01
  In Poster Session: PS 01 Topic - Developmental Psychopathology

Abstract

The percentage of pregnant women using cannabis rose a dramatic 106% between 2002 and 2016 (Volkow et al., 2019), coinciding with marked reductions in perception of risk associated with cannabis use (Compton et al., 2016). Prenatal cannabis exposure has been linked to outcomes such as reduced birthweight and premature birth, as well as psychosis and attention problems (Corsi et al., 2019; Day et al., 2015; Huizink, 2014; Leech et al., 1999); however, there has been little cross-study replication and inconsistent ability to account for important potential confounds. Spurred by these findings and trends in use and risk perception, the Surgeon General of the United States issued an advisory against the use of cannabis during pregnancy in the Summer of 2019. Here, we comprehensively extend prior research to investigate whether cannabis use during pregnancy is associated with childhood outcomes. Data came from 11,489 children (age 9.9±0.6 years; 47.8% female) participating in the baseline wave of the ongoing longitudinal Adolescent Brain and Cognitive Development Study℠ (ABCD Study®). Linear mixed effect models nesting the data by family and research site tested whether those exposed to cannabis after maternal knowledge of pregnancy and those exposed only before maternal knowledge had significantly different outcomes from those never exposed. Given that cannabinoid type 1 receptors, which mediate the actions of the primary psychoactive component of cannabis (THC), are not expressed until after many women learn they are pregnant, we expected that only associations with exposure after maternal knowledge of pregnancy would be robust to covariate inclusion. Examined outcomes included psychopathology (i.e., psychotic-like experiences (PLEs) and internalizing, externalizing, attention, thought, and social problems), sleep, birthweight, gestational age at birth, cognition, body mass index (BMI), and brain structure (i.e., total intracranial, white matter, and gray matter volumes). Covariates included familial (e.g., income, familial psychopathology), pregnancy (e.g., prenatal exposure to alcohol and tobacco), and child (e.g., substance use) variables. Relative to no exposure, cannabis exposure only before (n=413; 3.59%) and after (n=242; 2.11%) maternal knowledge of pregnancy were associated with greater offspring psychopathology characteristics and BMI as well as lower cognition and gray matter volume (all |ßs|>0.02, psfdr<0.03). Only exposure after knowledge of pregnancy was associated with lower birthweight and total intracranial and white matter volumes relative to no exposure and exposure only before knowledge (|ßs|>0.02, ps<0.002). When including potentially confounding covariates, exposure after maternal knowledge of pregnancy remained associated with greater PLEs and externalizing, attention, thought, and social problems (all |ßs|>0.02, psfdr<0.02). Exposure only before maternal knowledge of pregnancy did not differ from no exposure on any outcomes after covariate inclusion (all |ßs|<0.02, psfdr>0.70). These results show that prenatal cannabis exposure and its correlated factors are associated with greater risk for psychopathology during middle childhood. As such, cannabis use during pregnancy should be discouraged.

Authors

• Sarah E Paul, Washington University in St. Louis
  Presenting Author

• Alexander Hatoum, Washington University in St. Louis
  Non-Presenting Author

• Jeremy Fine, Washington University in St. Louis
  Non-Presenting Author

• Emma Johnson, Washington University at St. Louis
  Non-Presenting Author

• Isabella Hansen, Washington University in St. Louis
  Non-Presenting Author

• Nicole Karcher, Washington University in St. Louis
  Non-Presenting Author

• Allison Moreau, Washington University in St. Louis
  Non-Presenting Author

• Erin Bondy, Washington University in St. Louis
  Non-Presenting Author

• Yueyue Qu, Washington University in St. Louis
  Non-Presenting Author

• Ebony Carter, Washington University in St. Louis
  Non-Presenting Author

• Cynthia E. Rogers, Washington University School of Medicine
  Non-Presenting Author

• Arpana Agrawal, Washington University in St. Louis
  Non-Presenting Author

• Deanna Barch, Washington University in St. Louis
  Non-Presenting Author

• Ryan Bogdan, Washington University in St. Louis
  Non-Presenting Author