Long-term effects of prenatal cannabis exposure: Pathways to adolescent and adult outcomes

• Published in: Pharmacology, biochemistry and behavior biochemistry and behavior, 2022-03, Vol.214, p.173358-173358, Article 173358
• Main Authors: De Genna, Natacha M., Willford, Jennifer A., Richardson, Gale A.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Analgesics; Cannabinoid Receptor Agonists; Cannabis; Cannabis - adverse effects; Child; Endocannabinoids; Female; Gestational; Hallucinogens; Humans; Marijuana; Pregnancy; Prenatal; Prenatal Exposure Delayed Effects - chemically induced; Prospective Studies; Substance-Related Disorders - epidemiology
• ISSN: 0091-3057; 1873-5177
• DOI: 10.1016/j.pbb.2022.173358

With the increased prevalence, potency, and acceptability of cannabis use during pregnancy, it is important to understand the developmental effects of prenatal cannabis exposure (PCE). This review discusses methodological considerations for studies of PCE, including the assessment of exposures, covariates, and outcomes, and reviews findings from prospective, longitudinal studies of PCE. There is some evidence for associations between PCE and restricted growth at birth, but not for long-term effects on growth. PCE appears to have subtle yet enduring effects on memory and achievement in children and adolescents. Despite differences in sample demographics and measurement, there are remarkably consistent effects of PCE on externalizing behaviors, such as delinquency and substance use, which persist into adulthood. Longitudinal analyses demonstrate the importance of early cannabis initiation for pathways between PCE and adult functioning, including substance use and abuse, memory deficits, and psychotic symptoms. Animal studies demonstrate direct effects on the development of the brain via activation of endogenous endocannabinoid systems. Cannabis-induced activation of the endocannabinoid system causes alterations in the release of neurotransmitters and the modulation of brain plasticity in neural pathways that underlie cognition, motivation, and behavior regulation. Future research should consider cannabis use before pregnancy, the timing and route of exposure, polysubstance exposures, and inter-generational effects. •PCE may impact fetal growth, with no evidence of long-term effects on size.•Subtle effects on cognition are supported by neuroimaging and rodent studies.•PCE is associated with direct effects on behavior and brain function.•PCE has indirect effects on adult functioning via early initiation of cannabis use.