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Lo JO, Hedges JC, Chou WH, Tager KR, Bachli ID, Hagen OL, Murphy SK, Hanna CB, Easley CA. Influence of substance use on male reproductive health and offspring outcomes. Nat Rev Urol 2024:10.1038/s41585-024-00868-w. [PMID: 38664544 DOI: 10.1038/s41585-024-00868-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/30/2024]
Abstract
The prevalence of substance use globally is rising and is highest among men of reproductive age. In Africa, and South and Central America, cannabis use disorder is most prevalent and in Eastern and South-Eastern Europe, Central America, Canada and the USA, opioid use disorder predominates. Substance use might be contributing to the ongoing global decline in male fertility, and emerging evidence has linked paternal substance use with short-term and long-term adverse effects on offspring development and outcomes. This trend is concerning given that substance use is increasing, including during the COVID-19 pandemic. Preclinical studies have shown that male preconception substance use can influence offspring brain development and neurobehaviour through epigenetic mechanisms. Additionally, human studies investigating paternal health behaviours during the prenatal period suggest that paternal tobacco, opioid, cannabis and alcohol use is associated with reduced offspring mental health, in particular hyperactivity and attention-deficit hyperactivity disorder. The potential effects of paternal substance use are areas in which to focus public health efforts and health-care provider counselling of couples or individuals interested in conceiving.
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Affiliation(s)
- Jamie O Lo
- Department of Urology, Oregon Heath & Science University, Portland, OR, USA.
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA.
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA.
| | - Jason C Hedges
- Department of Urology, Oregon Heath & Science University, Portland, OR, USA
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA
| | - Wesley H Chou
- Department of Urology, Oregon Heath & Science University, Portland, OR, USA
| | - Kylie R Tager
- Department of Environmental Health Science, University of Georgia College of Public Health, Athens, GA, USA
| | - Ian D Bachli
- Department of Environmental Health Science, University of Georgia College of Public Health, Athens, GA, USA
| | - Olivia L Hagen
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Carol B Hanna
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Charles A Easley
- Department of Environmental Health Science, University of Georgia College of Public Health, Athens, GA, USA
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Bogdan R, Leverett SD, Constantino-Petit AM, Lashley-Simms N, Liss DB, Johnson EC, Lenze SN, Lean RE, Smyser TA, Carter EB, Smyser CD, Rogers CE, Agrawal A. Characteristics of women concordant and discordant for urine drug screens for cannabis exposure and self-reported cannabis use during pregnancy. Neurotoxicol Teratol 2024; 103:107351. [PMID: 38604316 DOI: 10.1016/j.ntt.2024.107351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/25/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Increasing cannabis use among pregnant people and equivocal evidence linking prenatal cannabis exposure to adverse outcomes in offspring highlights the need to understand its potential impact on pregnancy and child outcomes. Assessing cannabis use during pregnancy remains a major challenge with potential influences of stigma on self-report as well as detection limitations of easily collected biological matrices. OBJECTIVE This descriptive study examined the concordance between self-reported (SR) cannabis use and urine drug screen (UDS) detection of cannabis exposure during the first trimester of pregnancy and characterized concordant and discordant groups for sociodemographic factors, modes of use, secondhand exposure to cannabis and tobacco, and alcohol use and cotinine positivity. STUDY DESIGN The Cannabis Use During Development and Early Life (CUDDEL) Study is an ongoing longitudinal study that recruits pregnant individuals presenting for obstetric care, who report lifetime cannabis use as well as using (n = 289) or not using cannabis (n = 169) during pregnancy. During the first trimester pregnancy visit, SR of cannabis use and a UDS for cannabis, other illicit drugs and nicotine are acquired from eligible participants, of whom 333 as of 05/01/2023 had both. RESULTS Using available CUDDEL Study data on both SR and UDS (n = 333; age 26.6 ± 4.7; 88.6% Black; 45.4% below federal poverty threshold; 56.5% with paid employment; 89% with high school education; 22% first pregnancy; 12.3 ± 3.6 weeks gestation), we classified pregnant individuals with SR and UDS data into 4 groups based on concordance (k = 0.49 [95% C.I. 0.40-0.58]) between SR cannabis use and UDS cannabis detection during the first trimester: 1) SR+/UDS+ (n = 107); 2) SR-/UDS- (n = 142); 3) SR+/UDS- (n = 44); 4) SR-/UDS+ (n = 40). Those who were SR+/UDS- reported less frequent cannabis use and fewer hours under the influence of cannabis during their pregnancy. Those who were SR-/UDS+ were more likely to have joined the study at a lower gestational age with 62.5% reporting cannabis use during their pregnancy prior to being aware that they were pregnant. Of the 40 SR-/UDS+ women, 14 (i.e., 35%) reported past month secondhand exposure, or blunt usage. In the subset of individuals with SR and UDS available at trimester 2 (N = 160) and 3 (N = 140), concordant groups were mostly stable and > 50% of those in the discordant groups became concordant by the second trimester. Classifying individuals as exposed or not exposed who were SR+ and/or UDS+ resulted in minor changes in group status based on self-report at screening. CONCLUSION Overall, there was moderate concordance between SR and UDS for cannabis use/exposure during pregnancy. Instances of SR+/UDS- discordancy may partially be attributable to lower levels of use that are not detected on UDS. SR-/UDS+ discordancy may arise from recent use prior to knowledge of pregnancy, extreme secondhand exposure, deception, and challenges with completing questionnaires. Acquiring both self-report and biological detection of cannabis use/exposure allows for the examination of convergent evidence. Classifying those who are SR+ and/or UDS+ as individuals who used cannabis during their first trimester after being aware of their pregnancy resulted in only a minor change in exposure status; thus, relying on self-report screening, at least in this population and within this sociocultural context likely provides an adequate approximation of cannabis use during pregnancy.
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Affiliation(s)
- Ryan Bogdan
- Psychological & Brain Sciences, Washington University in Saint Louis, United States.
| | - Shelby D Leverett
- Division of Biology & Biomedical Sciences, Neurosciences Program, Washington University in Saint Louis, United States; Department of Psychiatry, Washington University in Saint Louis, United States
| | | | | | - David B Liss
- Department of Emergency Medicine, Washington University in Saint Louis, United States
| | - Emma C Johnson
- Department of Psychiatry, Washington University in Saint Louis, United States
| | - Shannon N Lenze
- Department of Psychiatry, Washington University in Saint Louis, United States
| | - Rachel E Lean
- Department of Psychiatry, Washington University in Saint Louis, United States
| | - Tara A Smyser
- Department of Psychiatry, Washington University in Saint Louis, United States
| | - Ebony B Carter
- Department of Obstetrics & Gynecology, Washington University in Saint Louis, United States
| | | | - Cynthia E Rogers
- Department of Psychiatry, Washington University in Saint Louis, United States
| | - Arpana Agrawal
- Department of Psychiatry, Washington University in Saint Louis, United States
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Ceasar RC, Terplan M, Rewegan A. Cannabis Use and Perinatal Health. JAMA 2024; 331:256-257. [PMID: 38227040 DOI: 10.1001/jama.2023.23236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Affiliation(s)
| | | | - Alex Rewegan
- History, Anthropology and Science, Technology, and Society, Massachusetts Institute of Technology, Cambridge
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Lo JO, Hedges JC, Metz TD. Cannabis Use and Perinatal Health-Reply. JAMA 2024; 331:257. [PMID: 38227037 DOI: 10.1001/jama.2023.23239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Affiliation(s)
- Jamie O Lo
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland
| | - Jason C Hedges
- Department of Urology, Oregon Health & Science University, Portland
| | - Torri D Metz
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City
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Venkatesh KK, Keim SA. Cannabis use in the preconception period: Does it increase the risk of gestational diabetes? Paediatr Perinat Epidemiol 2024; 38:86-88. [PMID: 38124545 DOI: 10.1111/ppe.13030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Kartik K Venkatesh
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Sarah A Keim
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
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Baranger DA. Evaluating Evidence Supporting an Effect of Prenatal Cannabis Exposure on White Matter Integrity. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:101-102. [PMID: 38298795 PMCID: PMC10829662 DOI: 10.1016/j.bpsgos.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 11/09/2023] [Indexed: 02/02/2024] Open
Affiliation(s)
- David A.A. Baranger
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
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Talavera-Barber MM, Morehead E, Ziegler K, Hockett C, Elliott AJ. Prenatal cannabinoid exposure and early language development. Front Pediatr 2023; 11:1290707. [PMID: 38078314 PMCID: PMC10702953 DOI: 10.3389/fped.2023.1290707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/31/2023] [Indexed: 02/12/2024] Open
Abstract
Introduction The effect of prenatal cannabis exposure (PCE) on childhood neurodevelopment remains poorly understood. There is a paucity of studies describing the neurodevelopment impact of PCE in infancy. The Mullen Scale of Early Learning (MSEL) is a cognitive screening tool that can be used from birth to 68 months and includes language and motor domains. Here we aim to explore the association between PCE during pregnancy and neurodevelopmental outcomes at 12 months of age. Methods Participants were pregnant persons/infant pairs enrolled in The Safe Passage Study, a large prospective cohort study. Inclusion criteria included data available on PCE with associated MSEL scores at 12 months of age. Exposed participants were defined as early exposure (1st trimester only) or late exposure (2nd or 3rd trimester) and were randomly matched with unexposed participants. Multiple linear regression models were performed to test associations between prenatal cannabis exposure and the five Mullen subscales: gross motor, fine motor, expressive language, receptive language, and visual reception. Results Sixty-nine exposed and 138 randomly matched unexposed infants were included in the analyses. Mothers of children with PCE were younger with the mean age 23.7 years for early exposure (n = 51) and 22.8 years for late exposure (n = 18). Maternal characteristics with prenatal cannabis use include a high-school education, American Indian or Alaska Native descent, lower socioeconomic status and co-use of tobacco. There were no gestational age or sex difference among the groups. Expressive (95% CI: 2.54-12.76; p = 0.0036,) and receptive language scores (95% CI: 0.39-8.72; p = 0.0322) were significantly increased between late-exposed infants compared to unexposed infants following adjustment for covariates. Gross motor scores (95% CI: 1.75-13; p = 0.0105) were also significantly increased for early-exposed infants with no difference in visual reception scores. Conclusion Preclinical studies have shown abnormal brain connectivity in offspring exposed to cannabis affecting emotional regulation, hyperactivity, and language development. Results from this study link PCE to altered early language development within the first year of life. Exposed infants demonstrated increased expressive and receptive language scores at 12 months of age, which can translate to better performance in school. However, further research is needed to determine the implications of these results later in childhood.
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Affiliation(s)
- Maria M. Talavera-Barber
- Avera Research Institute, Sioux Falls, SD, United States
- Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, United States
| | - Evlyn Morehead
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Katherine Ziegler
- Avera Research Institute, Sioux Falls, SD, United States
- Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, United States
| | - Christine Hockett
- Avera Research Institute, Sioux Falls, SD, United States
- Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, United States
| | - Amy J. Elliott
- Avera Research Institute, Sioux Falls, SD, United States
- Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, United States
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Baranger DA, Miller AP, Gorelik AJ, Paul SE, Hatoum AS, Johnson EC, Colbert SM, Smyser CD, Rogers CE, Bijsterbosch JD, Agrawal A, Bogdan R. Prenatal cannabis exposure is associated with localized brain differences that partially mediate associations with increased adolescent psychopathology. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.19.23295792. [PMID: 37790406 PMCID: PMC10543205 DOI: 10.1101/2023.09.19.23295792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Prenatal cannabis exposure (PCE) is associated with mental health problems, but the neurobiological mechanisms remain unknown. We find that PCE is associated with localized differences across neuroimaging metrics that longitudinally mediate associations with mental health in adolescence (n=9,322-10,186). Differences in brain development may contribute to PCE-related variability in adolescent mental health.
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Affiliation(s)
- David Aa Baranger
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, Missouri
| | - Alex P Miller
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Aaron J Gorelik
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, Missouri
| | - Sarah E Paul
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, Missouri
| | - Alexander S Hatoum
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, Missouri
| | - Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Sarah Mc Colbert
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, Missouri
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christopher D Smyser
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, Missouri
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Janine D Bijsterbosch
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Ryan Bogdan
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, Missouri
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Funding Grants Added. JAMA 2023; 330:1289. [PMID: 37698871 PMCID: PMC10498377 DOI: 10.1001/jama.2023.18690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
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Eidelman AI. Perinatal Cannabis Exposure, Via Placenta or Breast Milk. Breastfeed Med 2023; 18:713-714. [PMID: 37856657 DOI: 10.1089/bfm.2023.29258.editorial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Affiliation(s)
- Arthur I Eidelman
- -Arthur I. Eidelman, MD, FABM, Editor-in-Chief, Breastfeeding Medicine
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