Kleinhans Natalia M, Johnson Allegra J, Larsen Sarah F, Berkelhamer Sara K, Larimer Mary E, Dager Stephen R
Department of Radiology, University of Washington, Seattle, WA 98195, USA.
Integrated Brain Imaging Center, University of Washington, Seattle, WA 98195, USA.
Children (Basel). 2024 Nov 26;11(12):1436. doi: 10.3390/children11121436.
Pregnant women have limited information on the impact of prenatal cannabis exposure (PCE) alone. Our aim was to determine if PCE, without alcohol, tobacco, or illicit drug use, is associated with altered birth outcome measures in obstetrically low-risk women. In this observational cohort study, pregnant women were recruited between 2019 and 2022 from communities in Washington and Oregon, USA, and enrolled following their first trimester. PCE eligibility required a minimum of three days/week of cannabis use during the first trimester with no required minimum use thereafter. For all participants, illicit drug, nicotine, or alcohol use was exclusionary throughout pregnancy and monitored via urine toxicology at multiple time points. Cannabis use was quantified into delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) mg/day using product weight and potency. Outcome measures included gestational age, weight, length, head circumference, and Apgar scores. Study participants included 37 people in the PCE cohort and 35 controls. Average cannabis use for the PCE cohort was 198.0 mg of THC (SD = 221.2 mg)/day and 3.5 mg of CBD (SD = 4.3)/day. PCE newborns weighed less (38th vs. 52nd percentile, = 0.04) and were shorter (40th vs. 55th percentile, = 0.03) for their gestational age than controls. Female PCE newborns had smaller head circumference for gestational age (28th percentile; SD = 23), compared to male PCE newborns (55th percentile; SD = 32; = 0.02). PCE is associated with reduced birth weight and shorter length for gestational age. The effect of PCE on brain growth may be sexually dimorphic. Future PCE studies should include sex as a biological variable and longitudinally evaluate long-term developmental and physiological outcomes.
孕妇对于仅产前接触大麻（PCE）的影响了解有限。我们的目的是确定在无酒精、烟草或非法药物使用的情况下，PCE是否与产科低风险女性的出生结局指标改变有关。在这项观察性队列研究中，2019年至2022年期间从美国华盛顿州和俄勒冈州的社区招募孕妇，并在孕早期后入组。PCE入选标准要求在孕早期每周至少使用大麻三天，之后无最低使用量要求。对于所有参与者，整个孕期禁止使用非法药物、尼古丁或酒精，并在多个时间点通过尿液毒理学进行监测。使用产品重量和效力将大麻使用量量化为每日δ-9-四氢大麻酚（THC）和大麻二酚（CBD）毫克数。结局指标包括孕周、体重、身长、头围和阿氏评分。研究参与者包括37名PCE队列中的人和35名对照组。PCE队列的平均大麻使用量为每日198.0毫克THC（标准差=221.2毫克）和3.5毫克CBD（标准差=4.3）。与对照组相比，PCE新生儿的出生体重较轻（第38百分位对第52百分位，P=0.04），且根据孕周计算身长较短（第40百分位对第55百分位，P=0.03）。与男性PCE新生儿（第55百分位；标准差=32；P=0.02）相比，女性PCE新生儿根据孕周计算的头围较小（第28百分位；标准差=23）。PCE与出生体重降低和根据孕周计算的身长较短有关。PCE对大脑生长发育影响可能存在性别差异。未来关于PCE的研究应将性别作为生物学变量纳入，并纵向评估长期发育和生理结局。
