Cannabis During Pregnancy May Have Long Term Mental Health Consequences for Children What should readers take away from your report?

David Baranger: Our study suggests that elevated rates of psychopathology symptoms associated with perenatal cannabis exposure persist from ages 9-12. Early adolescence is a period with increased onset of mental health disorders. That these children have a greater mental health burden at this age suggests that they may be at risk for the onset of mental health disorders in adolescence.  

Ryan Bogdan Cutting to the chase, my interpretation of these findings is that clinicians and dispensaries should discourage use among women who are pregnant or are considering becoming pregnant. In no way do we establish a causal connection here – however, the potential impact of prenatal cannabis exposure on offspring documented through these associations gives us pause about the safety of cannabis use during pregnancy  

Ryan Bogdan I think we can use the highly effective public health campaigns and clinician attention directed toward reducing tobacco and alcohol use during pregnancy as an example for how we might address increasing cannabis use during pregnancy.  

Ryan Bogdan The other thing to clinically consider is how we as humans respond to information. We found that the association between prenatal cannabis exposure and child psychopathology symptoms were most strong and independent of confounding variables like tobacco and alcohol exposure, familial history of psychopathology, and child genetic risk when exposure occurred after the mother learned of pregnancy.

A mother who has just learned of her pregnancy and has previously used cannabis before knowing, might think, well I have already exposed the fetus to cannabis, so I may as well not reduce or stop my cannabis use. The current data might provide the clinician and mother with reason why stopping after learning of the pregnancy may reduce the likelihood of negative outcomes among their children. However, quitting substance use during pregnancy, which is already a challenging time, may not be straightforward. Physician support and empirical paradigms for quitting during pregnancy will be important. What recommendations do you have for future research as a result of this study?

Ryan Bogdan:  Beyond following this group of children as they age and develop, we are beginning studies to more closely study the effects of substance use on prenatal and infant development. We think it will be important to extend this work to early stages of brain and behavioral development – for example during the neonatal period and early childhood. Together with Cynthia Rogers, Arpana Agrawal, and others at Washington University in St. Louis, we are currently conducting a study that is recruiting pregnant women and assessing children shortly after birth so that we may understand neonatal associations with prenatal cannabis exposure. We are also part of a large national study, the HEALthy Brain and Child Development (HBCD) Study, that plans to recruit approximately 7,500 pregnant women across 30 sites within the United States to better understand how all kinds of prenatal exposures, genetic factors, and early experiences may shape early development, health, and behavior in early childhood. These studies will be important to assess the potential effects of prenatal exposures and other factors on early child development and health.  

It will also be important for more basic science to further elucidate the role of the endocannabinoid system in brain and behavioral development across the lifespan including during the prenatal period and how specific cannabis constituents (e.g., THC, CBD) may interact with this.


Baranger DAA, Paul SE, Colbert SMC, et al. Association of Mental Health Burden With Prenatal Cannabis Exposure From Childhood to Early Adolescence: Longitudinal Findings From the Adolescent Brain Cognitive Development (ABCD) Study. JAMA Pediatr. Published online September 12, 2022. doi:10.1001/jamapediatrics.2022.3191

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