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Space-Time Analysis of Burgeoning US Atrial Septal Defect Rates Driven by Cannabis.

Albert Stuart Reece1,2, Gary Kenneth Hulse1,2

  • 1Division of Psychiatry, University of Western Australia, Stirling Hwy, Crawley, Perth, WA 6009, Australia.

Journal of Xenobiotics
|April 27, 2026
PubMed
Summary

Cannabis use and legalization are significantly linked to the rising rates of atrial septal defect (ASD) in the US. This study suggests cannabinoids may be teratogenic, highlighting the need to control exposure.

Keywords:
cannabiscardiogenesisepigenotoxicitygenotoxicitytransgenerational inheritance

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Area of Science:

  • Public Health
  • Epidemiology
  • Environmental Health

Background:

  • Atrial septal defect (ASD) rates are increasing in the USA, affecting a significant portion of children.
  • Space-time analysis has not been previously applied to understand emerging trends in ASD.
  • Understanding the drivers of ASD is crucial for public health interventions.

Purpose of the Study:

  • To investigate the association between substance use, including cannabis, and atrial septal defect rates.
  • To apply space-time analysis to identify geographical and temporal patterns of ASD.
  • To determine if cannabis use or legalization correlates with increased ASD prevalence.

Main Methods:

  • Utilized National Birth Defects Prevention Network data (2003-2020) for ASD rates.
  • Incorporated National Survey of Drug Use and Health data for substance use and US Census data for income.
  • Performed time-sequential mapping and multivariate spatial regression analysis.

Main Results:

  • ASD rates showed a strong correlation with cannabis use indices, unlike other substances.
  • Cannabis and cannabinoids, particularly cannabidiol, were significantly associated with ASD (p=0.00002).
  • States with legal cannabis had higher ASD prevalence (OR=2.73), with high E-values supporting causality.

Conclusions:

  • Cannabis use and legalization appear to be significant drivers of the current US ASD epidemic.
  • Cannabis is identified as a potential teratogen, necessitating control of cannabinoid exposure.
  • Environmental contamination may be a factor in areas with high cannabis farming but lower reported use.