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Prenatal cannabis use and its impact on offspring neuro-behavioural outcomes: A systematic review
Mary Thompson1, Merima Vila2, Li Wang3
1Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada.
Insights
This review found no clear link between prenatal cannabis use and child neuro-behavioral outcomes like intelligence. However, the evidence is low quality, necessitating further research on cannabis exposure and child development.
Area of Science:
- Neuroscience
- Developmental Psychology
- Public Health
Background:
- Cannabis use during pregnancy is common, but its effects on child neurodevelopment are not well understood.
- Existing literature on prenatal cannabis exposure and offspring neuro-behavioral outcomes is limited.
Purpose of the Study:
- To systematically review and synthesize data on the impact of prenatal cannabis use on offspring intelligence and cognitive functioning.
- To assess the neuro-behavioral consequences for children exposed to cannabis in the womb.
Main Methods:
- A systematic search of multiple databases (MEDLINE, EMBASE, PsychINFO, CINAHL, Clinicaltrials.gov) was conducted.
- Observational studies comparing prenatal cannabis use to controls were included, with outcomes categorized into intelligence and cognitive functioning.
- Meta-analyses were performed where possible; otherwise, findings were summarized qualitatively using the GRADE framework for evidence certainty.
Main Results:
- Twenty-eight studies involving 523,107 patients were included. Significant heterogeneity limited meta-analysis.
- Very low-quality evidence indicated no significant associations between prenatal cannabis exposure and attention, global IQ, reading, written comprehension, spelling, or mathematics.
- While individual studies suggested differences in heavy use groups, pooled analyses did not confirm significant associations.
Conclusions:
- The current systematic review found no clear association between prenatal cannabis use and offspring neuro-behavioral outcomes.
- The evidence supporting these findings is of low quality and highly heterogeneous.
- Further prospective research is crucial to clarify potential associations between prenatal cannabis exposure and long-term neurodevelopmental outcomes.
Introduction:
Cannabis is a widely used substance in pregnancy, yet there is a paucity of literature addressing the neuro-behavioural consequences for prenatally exposed children. Our systematic review synthesizes currently available data for the impact of prenatal cannabis use on offspring intelligence and cognitive functioning.
Methods:
MEDLINE, EMBASE, PsychINFO, CINAHL, and Clinicaltrials.gov were searched. Observational studies comparing prenatal cannabis use to controls were included. Offspring neuro-behavioural outcomes were grouped in prespecified domains of (1) intelligence and (2) cognitive functioning. Random-effect models were performed for meta-analyses when at least three studies reported the same outcome. All others were summarized qualitatively. GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework was used to assess evidence certainty.
Results:
Of the 1982 reviewed studies (n = 523,107 patients), 28 were included. Significant heterogeneity and cohort redundancy limited meta-analysis. Very low-quality evidence from pooled analyses showed no significant associations between prenatal cannabis exposure and attention [standardized mean difference = -0.27 (95% CI = -0.60 to 0.07)], global intelligence quotient [-0.16 (-0.42 to 0.10)], reading [-0.05 (-0.29 to 0.20)], written comprehension [-0.09 (-0.40 to 0.22)], spelling [-0.04 (-0.26 to 0.17)], and mathematics [-0.01 (-0.15 to 0.13)]. No significant associations were found between prenatal cannabis exposure for all other outcomes. Individual studies reported significant differences between the heavy use groups and non-exposed, although this did not prove to be significant when outcomes were pooled.
Conclusions:
The current review did not find a clear association between prenatal cannabis use and offspring neuro-behavioural outcomes. However, evidence was low quality and heterogenous. Further prospective investigation is needed to elucidate any potential association between prenatal cannabis use and long-term neuro-developmental outcomes.
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