Implications of Prenatal Cannabis Exposure on Childhood Neurodevelopmental Outcomes: A Summary of the Clinical Evidence.

IF 4.3 4区 医学 Q1 OBSTETRICS & GYNECOLOGY
Sydney Mei Sheffield, Jeffrey A Kuller, Susan Kay Murphy, Sarah K Dotters-Katz, Jordan Enns Schaumberg
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引用次数: 0

Abstract

Importance: Cannabis is commonly used by pregnant patients for alleviation of pregnancy-associated symptoms. Multiple national medical associations have recommended against prenatal cannabis use, yet misinformation regarding its safety and efficacy remains prevalent in public discourse. Effective and evidence-based patient counseling on prenatal cannabis use requires a thorough understanding of the existing data on fetal neurodevelopment.

Objective: The aim of this study was to summarize the existing clinical literature on the impacts of intrauterine cannabis exposure on offspring neurodevelopment.

Evidence acquisition: Articles were identified via literature search in PubMed and OVID; relevant articles were reviewed.

Results: Limited data have shown associations between intrauterine cannabis exposure and (1) increased startles and difficulty with consolation in the neonatal period, (2) memory challenges, verbal reasoning challenges, and diminished academic performance during early childhood, and (3) inattention, hyperactivity, and aggression during early childhood. Further research with large and diverse samples that use objective measures of cannabis use across multiple time points in pregnancy is required to assess causation, the true extent of impacts, and dose-dependent effects.

Conclusions and relevance: The existing clinical data regarding the impacts of prenatal cannabis use on fetal neurodevelopment are limited by important confounders like genetic predisposition, concomitant tobacco and other substance use during pregnancy, and low socioeconomic status. However, the theoretical and demonstrated associations between prenatal cannabis use and adverse neurodevelopmental outcomes are compelling enough to warrant complete abstinence during pregnancy, pending further research. Providers can utilize this summary to offer data-driven guidance on prenatal cannabis use for pregnant patients.

产前大麻暴露对儿童神经发育结果的影响:临床证据摘要》。
重要性:孕妇常用大麻来缓解与妊娠有关的症状。多个国家的医学协会都建议不要在产前使用大麻,但有关其安全性和有效性的错误信息在公众讨论中仍很普遍。要就产前使用大麻为患者提供有效的循证咨询,就必须全面了解有关胎儿神经发育的现有数据:本研究旨在总结有关宫内大麻暴露对后代神经发育影响的现有临床文献:通过在 PubMed 和 OVID 上进行文献检索确定文章;对相关文章进行审查:有限的数据显示宫内大麻暴露与以下方面存在关联:(1) 新生儿期惊跳增加和安慰困难;(2) 幼儿期记忆障碍、语言推理障碍和学习成绩下降;以及 (3) 幼儿期注意力不集中、多动和攻击性。要评估因果关系、影响的真实程度以及剂量依赖效应,还需要对大量不同样本进行进一步研究,使用客观测量方法测量孕期多个时间点的大麻使用情况:有关产前使用大麻对胎儿神经发育影响的现有临床数据受到遗传易感性、孕期同时使用烟草和其他物质以及社会经济地位低下等重要混杂因素的限制。然而,产前吸食大麻与不良神经发育结果之间的理论联系和已证实的联系足以令人信服,因此在进一步研究之前,有必要在孕期完全禁用大麻。医疗服务提供者可利用本摘要为怀孕患者提供以数据为导向的产前使用大麻指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.70
自引率
3.20%
发文量
245
审稿时长
>12 weeks
期刊介绍: ​Each monthly issue of Obstetrical & Gynecological Survey presents summaries of the most timely and clinically relevant research being published worldwide. These concise, easy-to-read summaries provide expert insight into how to apply the latest research to patient care. The accompanying editorial commentary puts the studies into perspective and supplies authoritative guidance. The result is a valuable, time-saving resource for busy clinicians.
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