Department of Child and Adolescent Psychiatry-Psychology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, the Netherlands; Generation R Study Group, Erasmus Medical Centre, Rotterdam, the Netherlands.
Department of Psychiatry, Erasmus Medical Centre, Rotterdam, the Netherlands.
Schizophr Res. 2018 Dec;202:322-327. doi: 10.1016/j.schres.2018.06.067. Epub 2018 Jul 6.
Cannabis use continues to increase among pregnant women. Gestational cannabis exposure has been associated with various adverse outcomes. However, it remains unclear whether cannabis use during pregnancy increases the risk for offspring psychotic-like experiences. In this prospective cohort, we examined the relationship between parental cannabis use during pregnancy and offspring psychotic-like experiences. Comparisons were made between maternal and paternal cannabis use during pregnancy to investigate causal influences of intra-uterine cannabis exposure during foetal neurodevelopmental. This study was embedded in the Generation R birth cohort and included N = 3692 participants. Maternal cannabis exposure was determined using self-reports and cannabis metabolite levels from urine. Paternal cannabis use during pregnancy was obtained by maternal report. Maternal cannabis use increased the risk of psychotic-like experiences in the offspring (OR = 1.38, 95% CI 1.03-1.85). Estimates were comparable for maternal cannabis use exclusively before pregnancy versus continued cannabis use during pregnancy. Paternal cannabis use was similarly associated with offspring psychotic-like experiences (OR = 1.44, 95% CI 1.14-1.82). We demonstrated that both maternal and paternal cannabis use were associated with more offspring psychotic-like experiences at age ten years. This may suggest that common aetiologies, rather than solely causal intra-uterine mechanisms, underlie the association between parental cannabis use and offspring psychotic-like experiences. These common backgrounds most likely reflect genetic vulnerabilities and shared familial mechanisms, shedding a potential new light on the debated causal path from cannabis use to psychotic-like phenomena. Our findings indicate that diagnostic screening and preventative measures need to be adapted for young people at risk for severe mental illness.
孕妇的大麻使用量持续增加。妊娠期大麻暴露与各种不良后果有关。然而，目前尚不清楚怀孕期间使用大麻是否会增加后代出现精神病样体验的风险。在这项前瞻性队列研究中，我们研究了怀孕期间父母使用大麻与后代出现精神病样体验之间的关系。比较了怀孕期间母亲和父亲使用大麻的情况，以调查胎儿神经发育过程中宫内大麻暴露的因果影响。本研究嵌入了 Generation R 出生队列，共纳入了 3692 名参与者。通过自我报告和尿液中的大麻代谢物水平来确定母亲的大麻暴露情况。通过母亲报告来获取父亲怀孕期间使用大麻的情况。母亲怀孕期间使用大麻会增加后代出现精神病样体验的风险（OR=1.38，95%CI 1.03-1.85）。对于母亲仅在怀孕前使用大麻与持续怀孕期间使用大麻的情况，估计值是可比的。父亲使用大麻与后代出现精神病样体验也有类似的关联（OR=1.44，95%CI 1.14-1.82）。我们表明，母亲和父亲使用大麻都会导致 10 岁时更多的后代出现精神病样体验。这可能表明，在父母使用大麻与后代出现精神病样体验之间的关联中，共同的病因学机制，而不仅仅是单纯的宫内因果机制。这些共同的背景最有可能反映了遗传脆弱性和共同的家庭机制，为从大麻使用到精神病样现象的争论性因果路径提供了新的潜在视角。我们的研究结果表明，需要针对有严重精神疾病风险的年轻人进行诊断筛查和预防措施的调整。
