Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
Paediatr Perinat Epidemiol. 2020 Nov;34(6):744-756. doi: 10.1111/ppe.12693. Epub 2020 Aug 3.
Marijuana is the most-used illicit substance during pregnancy in the USA, but only two cohort studies, begun over 30 years ago, were specifically established to assess the association of pregnancy use with childhood outcomes. They found use to be associated with specific deficits in executive function at 8+ years, but did not focus on these outcomes earlier in life when intervention may be more successful. Two general purpose cohorts found increased aggression in exposed female toddlers and increased behavioural problems and tic disorders in exposed school-age children.
The Lifestyle and Early Achievement in Families (LEAF) study assesses the association of in utero marijuana exposure, documented prospectively by biomarker, self-report, and medical records, with executive function and aggression at age 3½-7 years.
This ambidirectional cohort (historical cohort with continued follow-up) includes women enrolled in the Perinatal Research Repository during prenatal care at Ohio State University Wexner Medical Center and their children, recontacted 3½-7 years post-birth. Children complete 1-2 study visits including cognitive testing, behavioural observation, and maternal and teacher report of behaviour. Family and social environmental factors are assessed.
Child follow-up began in September 2016; visits continue through August 2020. There are 362 eligible children; 32% had mothers who used marijuana during pregnancy, 10% of mothers completed college, and 23% did not complete high school. Mean maternal age at study registration in pregnancy was 26.4 years, and 63% of mothers were African American. To date, 268 children have completed at least 1 study visit.
The LEAF Study will document the association of prenatal marijuana exposure with development and behaviour in the current era when marijuana is more potent than when previous cohorts were studied. The results may inform policy and interventions to counsel reproductive-aged women about the risks of use during pregnancy and guide prevention and treatment of adverse effects among children.
在美国，大麻是孕妇最常使用的非法物质，但只有两项队列研究是专门为评估妊娠期间使用大麻与儿童结局的关联而在 30 多年前开始的。这两项研究发现，使用大麻与 8 岁以上儿童的特定执行功能缺陷有关，但并未关注生命早期的这些结果，因为此时干预可能更成功。两项通用队列研究发现，暴露于大麻的女幼童攻击性增强，暴露于大麻的学龄儿童行为问题和抽动障碍增多。
生活方式和家庭早期成就（LEAF）研究评估了通过生物标志物、自我报告和医疗记录前瞻性记录的宫内大麻暴露与 3 岁半至 7 岁儿童执行功能和攻击性的关联。
这是一个双向队列（具有持续随访的历史队列），包括在俄亥俄州立大学韦克斯纳医疗中心产前护理期间参加围产期研究存储库的女性及其子女，在出生后 3 岁半至 7 岁时重新联系。儿童完成 1-2 次研究访问，包括认知测试、行为观察以及母亲和教师对行为的报告。评估家庭和社会环境因素。
儿童随访于 2016 年 9 月开始；访问持续到 2020 年 8 月。共有 362 名符合条件的儿童；32%的母亲在怀孕期间使用大麻，10%的母亲完成了大学学业，23%的母亲没有完成高中学业。母亲在妊娠期间登记参加研究时的平均年龄为 26.4 岁，63%的母亲为非裔美国人。迄今为止，已有 268 名儿童至少完成了 1 次研究访问。
LEAF 研究将记录当前大麻更有效时期妊娠期间使用大麻与发育和行为的关联。研究结果可能为政策和干预措施提供信息，以就怀孕期间使用大麻的风险向育龄妇女提供咨询，并指导儿童的预防和治疗不良影响。
