BACKGROUND AND PURPOSE:

• The impacts of cannabis exposure in utero are not well understood, even though use in pregnancy is increasing
• Studies have been inconsistent especially related to caregiver perceptions  
• Keim et al. (JAMA Pediatrics, 2024) investigated the association of prenatal cannabis exposure with executive function and aggressive behavior at age 5 years

METHODS:

• Prospective cohort study
  • The Lifestyle and Early Achievement in Families (LEAF) cohort
  • Derived from women enrolled during pregnancy into the Ohio Perinatal Research Network Perinatal Research Repository (PRR)
• Participants
  • Patients who gave birth at age 16 to 50 years
  • 5-year-old children
• Exposure
  • Cannabis
    • Measurements: Urine toxicology | Maternal self-report | Obstetric record abstraction
• Primary outcome
  • Executive function and aggressive behavior
    • Measurement: Multimodal assessment by staff masked to exposure status

RESULTS:

• 250 children
  • Exposed to cannabis: 32%
  • Exposure to other substances (e.g., tobacco, drugs, and alcohol) also common
  • Majority of families were living in poverty
  • Non-Hispanic Black: 62% | Hispanic: 4% | 2 or more races: 14% | Non-Hispanic White: 20%
• Age-corrected standard scores for children’s attention and inhibitory control (National Institutes of Health Toolbox) were lower for those exposed to cannabis compared with unexposed
  • β −6.1 points (95% CI, −10.8 to −1.4)
• Exposed children exhibited poorer task-based planning ability and more observed aggression
• Caregiver ratings were not different based on exposure status

CONCLUSION:

• Children exposed to cannabis in utero displayed some evidence of reduced executive function and increased aggression
• The authors state

These outcomes are relevant to long-term academic and adaptive functioning

The present findings may inform counseling by clinicians to avoid cannabis use during pregnancy, particularly given its recent increase

Learn More – Primary Sources:

Prenatal Cannabis Exposure and Executive Function and Aggressive Behavior at Age 5 Years