Impact of prenatal exposure to delta 9-tetrahydrocannabinol and cannabidiol on birth size and postnatal growth trajectories

Brianna F Moore; Noel T Mueller; Wei Perng; Katherine A Sauder; Emily T Hébert; Adrienne T Hoyt; Erica M Wymore; Kristen E Boyle; Emily J Su; Allison L B Shapiro; Gregory Kinney; Cristina Sempio; Jost Klawitter; Uwe Christians; Dana Dabelea

doi:10.1111/ijpo.13187

Impact of prenatal exposure to delta 9-tetrahydrocannabinol and cannabidiol on birth size and postnatal growth trajectories

Pediatr Obes. 2024 Dec 16:e13187. doi: 10.1111/ijpo.13187. Online ahead of print.

Authors

Brianna F Moore^{1

2}, Noel T Mueller^{1

2

3}, Wei Perng^{1

2}, Katherine A Sauder⁴, Emily T Hébert⁵, Adrienne T Hoyt⁵, Erica M Wymore³, Kristen E Boyle^{2

3}, Emily J Su⁶, Allison L B Shapiro^{2

3}, Gregory Kinney¹, Cristina Sempio⁷, Jost Klawitter⁷, Uwe Christians⁷, Dana Dabelea^{1

2

3}

Affiliations

¹ Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA.
² Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
³ Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
⁴ Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
⁵ Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center, Austin, Texas, USA.
⁶ Department of Obstetrics and Gynecology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
⁷ Department of Anesthesiology, University of Colorado School of Medicine, Colorado, Aurora, USA.

PMID: 39681476
DOI: 10.1111/ijpo.13187

Abstract

Background: Prenatal exposure to cannabis (or more specifically, delta 9-tetrahydrocannabinol [Δ9-THC]) has been consistently linked to low birthweight. Animal models further show that Δ9-THC is associated with rapid postnatal growth. Whether this association is modified by breastfeeding is unknown.

Methods: In this exploratory study, we followed 128 mother-child pairs through 3 years. Urinary Δ9-THC and cannabidiol (CBD) were measured mid-gestation. Generalized linear models estimated the associations between Δ9-THC and neonatal body composition. A mixed-effects model estimated the association between Δ9-THC and body mass index (BMI) z-score trajectories. Interaction was assessed by a three-way product term (Δ9-THC × breastmilk months × age).

Results: Fifteen children (12%) had Δ9-THC exposure; three had concomitant CBD exposure. Prenatal exposure to Δ9-THC alone was associated with lower fat mass (-95 g, 95% confidence interval [CI]: -174, -14) and neonatal adiposity (-2.1%; 95% CI: -4.2, -0.4) followed by rapid postnatal growth (0.42 increase in BMI z-score per square root year; 95% CI: 0.12, 0.72). Breastfeeding modified this association (p = 0.04), such that growth was similar for those breastfed for 5 months whereas a shorter duration of breastfeeding was associated with 1.1 higher BMI z-score at 3 years (95% CI: 0.21, 2.05).

Conclusions: Our study suggests that prenatal exposure to Δ9-THC may alter early-life growth. Breastfeeding may stabilize rapid postnatal growth, but the impact of lactational exposure requires further investigation.

Keywords: BMI; adiposity; breastfeeding; cannabidiol; cannabis; delta‐9‐tetrahydrocannabinol; foetal growth restriction; growth trajectory; postnatal weight gain.

Abstract

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