Prenatal Cannabis Use and Offspring Attention Deficit Hyperactivity Disorder and Disruptive Behavior Disorders: A Retrospective Cohort Study.
Kelly C Young-Wolff, Kevin Kong, Stacey E Alexeeff and 7 others
PMID 39400201WHAT IT FOUND
Prenatal cannabis use was not associated with increased risk of offspring ADHD or disruptive behavior disorders.
Fully adjusted models showed no significant increase in ADHD risk and a lower risk of disruptive behavior disorders, likely due to detection bias rather than protection.
Key findings
01After adjusting for sociodemographics, other substance use, prenatal care, and maternal comorbidities, any prenatal cannabis use was not significantly associated with offspring ADHD.
02In fully adjusted models, any prenatal cannabis use was inversely associated with offspring disruptive behavior disorders.
03The inverse association with disruptive behavior disorders and the suggestive inverse association with ADHD may be driven by residual confounding, such as parents being less likely to notice symptoms or seek assessment.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study relied on electronic health record diagnoses rather than comprehensive diagnostic assessments, which likely underestimates the true prevalence of ADHD and DBD. Cannabis exposure was measured only at a single time point (8-10 weeks gestation), with no data on continued use, potency, or mode of administration throughout pregnancy. The cohort was limited to children enrolled in the health system at age 4, potentially excluding those with poorer outcomes who left the system earlier. Postpartum maternal substance use was not adjusted for, which could act as a mediator or confounder. The inverse associations found may be due to detection bias, where mothers who do not disclose cannabis use are less likely to notice or report behavioral symptoms in their children.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not interpret the lower risk of disruptive behavior disorders as evidence that prenatal cannabis use is protective. This finding is likely due to detection bias, where parents who do not disclose substance use may be less likely to notice or seek assessment for their child's behavioral symptoms.