Division of Research, Kaiser Permanente Northern California, Pleasanton.
Bernard J. Tyson Kaiser Permanente School of Medicine, Pasadena, California.
JAMA Netw Open. 2024 Oct 1;7(10):e2440295. doi: 10.1001/jamanetworkopen.2024.40295.
Maternal prenatal cannabis use is associated with adverse neonatal health effects, yet little is known about its association with child developmental outcomes.
To evaluate associations between maternal prenatal cannabis use in early pregnancy and child early developmental delays.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study included 119 976 children born to 106 240 unique individuals between January 2015 and December 2019 and followed up to aged 5.5 years or younger (through December 31, 2021) at Kaiser Permanente Northern California. Individuals were screened for prenatal cannabis use via self-report and urine toxicology at entrance into prenatal care (approximately 8- to 10-weeks' gestation). Data were analyzed from February 2023 to March 2024.
Maternal prenatal cannabis use defined as any use (self-reported or by urine toxicology testing) and use frequency.
Early developmental delays (speech and language disorders, motor delays, global delays) in children up to age 5.5 years defined by International Statistical Classification of Diseases and Related Health Problems, Ninth Revision and Tenth Revision diagnoses codes ascertained from electronic health records.
In this cohort of 119 976 pregnancies among 106 240 unique pregnant individuals, there were 29 543 Hispanic pregnancies (24.6%), 6567 non-Hispanic Black pregnancies (5.5%), 46 823 non-Hispanic White pregnancies (39.0%), 12 837 pregnancies (10.7%) to individuals aged 24 years or younger, and 10 365 pregnancies (8.6%) to individuals insured by Medicaid. Maternal prenatal cannabis use was documented for 6778 pregnancies (5.6%). Daily maternal prenatal cannabis use was reported for 618 pregnancies (0.5%), weekly for 722 pregnancies (0.6%), and monthly or less for 1617 pregnancies (1.3%). No association was observed between maternal prenatal cannabis use and child speech and language disorders (HR, 0.93; 95% CI, 0.84-1.03), global developmental delays (HR, 1.04; 95% CI, 0.68-1.59), or motor delays (HR, 0.86; 95% CI, 0.69-1.06). No association was detected between the frequency of maternal prenatal cannabis use and child early developmental delays.
In this cohort study, maternal prenatal cannabis use was not associated with an increased risk of child early developmental delays. Future research is needed to assess different patterns of cannabis use throughout pregnancy. Given the association between maternal prenatal cannabis use and other adverse outcomes, pregnant individuals should be educated on those risks.
母体产前大麻使用与新生儿健康不良影响有关，但对于其与儿童发育结果的关系知之甚少。
评估母体产前大麻在妊娠早期使用与儿童早期发育迟缓之间的关系。
设计、地点和参与者：这项队列研究纳入了 2015 年 1 月至 2019 年 12 月间在 Kaiser Permanente Northern California 登记的 119976 名儿童，他们的母亲在 106240 名独特个体中。在产前保健时（大约妊娠 8-10 周），通过自我报告和尿液毒理学筛查个体是否存在产前大麻使用。数据于 2023 年 2 月至 2024 年 3 月进行分析。
母体产前大麻使用定义为任何使用（自我报告或尿液毒理学检测）和使用频率。
5.5 岁以下儿童的早期发育迟缓（言语和语言障碍、运动迟缓、全面迟缓），通过电子健康记录确定国际疾病分类和相关健康问题第十版诊断代码。
在这项队列研究中，在 106240 名孕妇中，有 29543 名西班牙裔孕妇（24.6%）、6567 名非西班牙裔黑人孕妇（5.5%）、46823 名非西班牙裔白人孕妇（39.0%）、12837 名年龄在 24 岁及以下的孕妇和 10365 名接受医疗补助保险的孕妇。有 6778 名孕妇（5.6%）记录了母体产前大麻使用情况。有 618 名孕妇（0.5%）报告了每日使用、722 名孕妇（0.6%）报告了每周使用、1617 名孕妇（1.3%）报告了每月或更少使用。母体产前大麻使用与儿童言语和语言障碍（HR，0.93；95%CI，0.84-1.03）、全面发育迟缓（HR，1.04；95%CI，0.68-1.59）或运动迟缓（HR，0.86；95%CI，0.69-1.06）之间无关联。母体产前大麻使用频率与儿童早期发育迟缓之间也未发现关联。
在这项队列研究中，母体产前大麻使用与儿童早期发育迟缓的风险增加无关。未来的研究需要评估整个孕期不同模式的大麻使用情况。鉴于母体产前大麻使用与其他不良后果之间的关联，应向孕妇宣传这些风险。
