Corsi Daniel J, Morris Tim T, Reed Zoe E, Davey Smith George
Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
CHEO Research Institute, CPCR Building, Rm L1132, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
Eur J Epidemiol. 2025 May 12. doi: 10.1007/s10654-025-01233-w.
Maternal cannabis use in pregnancy is reported to be associated with perinatal and neurodevelopmental outcomes in offspring. Such associations, however, may be biased by residual confounding by socioeconomic position (SEP). To assess confounding, we use paternal cannabis use in pregnancy as a negative control exposure. We use data from 15,013 mother-father-child trios from the ALSPAC birth cohort, with participants initially recruited between 1990 and 1992. Exposures were maternal and paternal cannabis use during pregnancy. Neonatal anthropometry, perinatal, cognitive, and neurodevelopmental outcomes were modelled as a function of maternal and paternal cannabis use in pregnancy, adjusting for household-level SEP markers and maternal and paternal tobacco, alcohol, and drug use in pregnancy. We compared the strength of the association between maternal and paternal cannabis on outcomes using Wald tests. 5 and 13% of mothers and fathers reported cannabis use, which was inversely related to measures of SEP. Maternal cannabis use during pregnancy was associated with decreased infant birth weight (b = - 110.2 g, 95% CI - 185.1 to - 35.3 for any cannabis use) and length (b = - 0.45 cm, 95% CI - 0.84 to - 0.07). Maternal cannabis during pregnancy was also associated with neonatal special care admission (odds ratio 1.64, 95% CI 1.05 to 2.56) and lower education achievement scores at age 16 (b = - 19.2, 95% CI - 32.0 to - 6.3). Maternal cannabis use in pregnancy was modestly associated with perinatal outcomes and markers of cognitive development. However, most associations were attenuated after controlling for potential confounders, including SEP, and associations were not quantitatively different from paternal cannabis use. The association of maternal cannabis use in pregnancy with perinatal or cognitive outcomes in offspring may be driven by residual confounding, including SEP, rather than causal biological effects.
据报道，孕期母亲使用大麻与后代的围产期和神经发育结局有关。然而，这种关联可能会受到社会经济地位（SEP）残留混杂因素的影响。为了评估混杂因素，我们将孕期父亲使用大麻作为阴性对照暴露因素。我们使用了来自阿冯纵向父母与儿童发育研究（ALSPAC）出生队列的15013对母婴-父亲三元组数据，参与者最初于1990年至1992年招募。暴露因素为孕期母亲和父亲使用大麻。将新生儿人体测量、围产期、认知和神经发育结局建模为孕期母亲和父亲使用大麻的函数，并对家庭层面的SEP指标以及孕期母亲和父亲使用烟草、酒精和药物的情况进行了调整。我们使用Wald检验比较了母亲和父亲使用大麻与结局之间关联的强度。5%和13%的母亲和父亲报告使用过大麻，这与SEP指标呈负相关。孕期母亲使用大麻与婴儿出生体重降低（b=-110.2克，95%置信区间-185.1至-35.3，任何大麻使用情况）和身长降低（b=-0.45厘米，95%置信区间-0.84至-0.07）有关。孕期母亲使用大麻还与新生儿入住特殊护理病房（比值比1.64，95%置信区间1.05至2.56）以及16岁时较低的教育成就得分（b=-19.2，95%置信区间-32.0至-6.3）有关。孕期母亲使用大麻与围产期结局和认知发育指标存在适度关联。然而，在控制包括SEP在内的潜在混杂因素后，大多数关联减弱，且这些关联与父亲使用大麻在数量上没有差异。孕期母亲使用大麻与后代围产期或认知结局之间的关联可能是由包括SEP在内的残留混杂因素驱动的，而非因果生物学效应。
