Maternal Cannabis Use During Pregnancy and Neuropsychiatric Adverse Outcomes During Childhood and Early Adult Life.

This review looked at studies examining whether using cannabis during pregnancy affects children's brain development and behavior. Research suggests links to increased risk of autism, ADHD, attention problems, behavioral issues, and social difficulties in children. However, the studies had significant limitations and findings were inconsistent with small effects. The authors note that cannabis today is much stronger than in past studies, so current risks may be underestimated.

This review examines research on neuropsychiatric outcomes in children following prenatal cannabis exposure. The analysis suggests associations between maternal cannabis use during pregnancy and increased risks of autism spectrum disorder, ADHD, psychosis-related symptoms, behavioral problems, attention difficulties, social problems, impaired executive function, and aggression in offspring. However, the review notes significant methodological limitations including retrospective exposure assessment, screening-based rather than formal diagnostic assessments, inadequate control for confounding variables, and small effect sizes with inconsistent findings across studies. The authors emphasize that current research may underestimate risks given increasing cannabis potency and recommend caution regarding cannabis use during pregnancy.

While associations are reported between prenatal cannabis exposure and neuropsychiatric outcomes including autism and ADHD, methodological limitations prevent definitive conclusions. Clinicians should be aware of potential risks when counseling pregnant women, while recognizing that current research may underestimate effects given increasing cannabis potency.

Significant methodological concerns including retrospective exposure assessment, screening rather than formal diagnostic evaluation, inadequate control for confounding variables, and inconsistent findings with small effect sizes. Many studies lacked details about cannabis characteristics and childhood adverse experiences.

Cannabis use during pregnancy is increasing; the study of adverse outcomes in cannabis-exposed pregnancies is therefore important. Previous articles in this series described increased risks of maternal adverse outcomes, fetal adverse outcomes, birth defects in newborns, and autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in childhood. This article examines neuropsychiatric adverse outcomes in offspring gestationally exposed to cannabis. Currently available research suggests that prenatal cannabis exposure is associated with increased risks of ASD, ADHD, psychosis proneness, psychotic like experiences, internalizing problems, externalizing problems, attention problems, thought-related problems, social problems, impaired executive function, and observed aggression.

There is insufficient study of prenatal cannabis exposure and offspring IQ. Shortcomings in the existing literature are discussed; as examples, many outcomes were determined by screening rather than by formal assessment, prenatal cannabis exposure was ascertained retrospectively in some studies, childhood adverse experiences and exposures were seldom included as covariates, and details about cannabis use (source, potency, frequency, reasons) were unavailable. Curiously, the findings of adverse outcomes were inconsistent, and the effect sizes were small. Possible explanations are that women who use cannabis during pregnancy may not admit it and their pregnancy outcomes may then be misclassified into the control group, assessment of outcomes at too young an age or with insufficient accuracy may blur differences between exposed and unexposed groups, and adjustment for covariates may mask the full effects of cannabis.

A last observation is that the studies reviewed were based on exposures that occurred decades ago. Given the increasing potency of currently available cannabis and the limitations of the existing research, it is possible that the available findings underestimate the breadth and severity of the risks. Cannabis is not a necessary substance for use during pregnancy, and so women who consider it safe might do well to guard against complacency and unnecessary exposure.