Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado80045, USA.
Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado80045, USA.
Psychol Med. 2020 Jul;50(10):1716-1726. doi: 10.1017/S003329171900179X. Epub 2019 Jul 31.
This study investigated whether higher maternal choline levels mitigate effects of marijuana on fetal brain development. Choline transported into the amniotic fluid from the mother activates α7-nicotinic acetylcholine receptors on fetal cerebro-cortical inhibitory neurons, whose development is impeded by cannabis blockade of their cannabinoid-1(CB1) receptors.
Marijuana use was assessed during pregnancy from women who later brought their newborns for study. Mothers were informed about choline and other nutrients, but not specifically for marijuana use. Maternal serum choline was measured at 16 weeks gestation.
Marijuana use for the first 10 weeks gestation or more by 15% of mothers decreased newborns' inhibition of evoked potentials to repeated sounds (d' = 0.55, p < 0.05). This effect was ameliorated if women had higher gestational choline (rs = -0.50, p = 0.011). At 3 months of age, children whose mothers continued marijuana use through their 10th gestational week or more had poorer self-regulation (d' = -0.79, p < 0.05). This effect was also ameliorated if mothers had higher gestational choline (rs = 0.54, p = 0.013). Maternal choline levels correlated with the children's improved duration of attention, cuddliness, and bonding with parents.
Prenatal marijuana use adversely affects fetal brain development and subsequent behavioral self-regulation, a precursor to later, more serious problems in childhood. Stopping marijuana use before 10 weeks gestational age prevented these effects. Many mothers refuse to cease use because of familiarity with marijuana and belief in its safety. Higher maternal choline mitigates some of marijuana's adverse effects on the fetus.
本研究旨在探讨母体胆碱水平是否能减轻大麻对胎儿大脑发育的影响。胆碱从母体转运到羊水后，会激活胎儿大脑皮质抑制神经元上的α7-烟碱型乙酰胆碱受体，而大麻会阻断这些神经元上的大麻素 1（CB1）受体，从而阻碍其发育。
本研究通过对之后带新生儿前来研究的孕妇在怀孕期间使用大麻的情况进行评估。母亲们被告知了胆碱和其他营养物质的相关信息，但并未特别告知她们与大麻使用相关的内容。在妊娠 16 周时测量了母体血清中的胆碱含量。
15%的母亲在妊娠前 10 周或更久的时间内大量使用大麻，会降低新生儿对重复声音的抑制性诱发电位（d'=0.55，p<0.05）。如果女性的妊娠胆碱水平较高（rs=-0.50，p=0.011），这种影响会减轻。在 3 个月大时，如果母亲在妊娠第 10 周或更久仍持续使用大麻，其子女的自我调节能力会更差（d'=-0.79，p<0.05）。如果母亲的妊娠胆碱水平较高（rs=0.54，p=0.013），这种影响也会减轻。母体胆碱水平与儿童注意力持续时间、可爱度和与父母的亲密程度呈正相关。
产前大麻使用会对胎儿大脑发育和随后的行为自我调节产生不利影响，这是儿童后期更严重问题的前兆。在妊娠 10 周前停止使用大麻可以预防这些影响。许多母亲因对大麻的熟悉和对其安全性的信任而拒绝停止使用。母体胆碱水平的升高可以减轻大麻对胎儿的一些不良影响。
