目的:评估怀孕期间使用大麻与后代长期神经精神病理学风险之间的关系。
方法:MEDLINE,EMBASE,和Cochrane图书馆数据库进行了系统搜索,直到2024年1月22日,没有语言或日期限制。
方法:如果研究报告了母亲在怀孕期间使用大麻用于医疗或娱乐用途的后代的任何长期神经精神结局的定量数据,则有资格纳入研究。通过任何途径和任何三个月,与怀孕期间放弃使用大麻的妇女的后代相比。所有观察性研究设计均包括在分析中。
方法:根据PRISMA和MOOSE指南进行系统评价和荟萃分析。数据由两名审阅者独立提取。以下后代结果值得关注:注意力缺陷/多动障碍(ADHD),自闭症谱系障碍(ASD),抑郁症,焦虑,精神病,以及大麻和其他物质的使用。与未接触大麻的女性相比,在怀孕期间暴露于大麻的女性的后代中,每种神经精神结局的赔率比(OR)和95%置信区间(CI)进行了汇总。使用随机效应模型汇集数据。
结果:18项符合条件的观察性研究纳入了系统评价,17个被纳入最终的定量分析,代表534,445名与会者。在调整了混杂因素后,ADHD的合并OR为1.13(95%CI1.01-1.26);对于ASD,合并OR为1.04(95%CI0.74-1.46);对于精神病性症状,汇总OR为1.29(95%CI0.97-1.72);对于焦虑,合并OR为1.34(95%CI0.79-2.29);对于抑郁症,合并OR为0.72(95%CI0.11-4.57);对于后代使用大麻,合并OR为1.20(95%CI1.01-1.42).
结论:产前大麻暴露与ASD风险增加无关,精神病症状,焦虑,或者后代的抑郁症。然而,它可能会略微增加多动症的风险,并使后代容易食用大麻。尽管有这些发现,怀孕期间使用大麻需要谨慎。进一步的研究势在必行,特别是考虑到近年来大麻的效力越来越高。
OBJECTIVE: To evaluate the association between cannabis use during pregnancy and the risk for long-term neuropsychiatric pathology in the offspring.
METHODS: MEDLINE, EMBASE, and Cochrane library databases were systematically searched until January 22, 2024, with no language or date restrictions.
METHODS: Studies were eligible for inclusion if they reported quantitative data on any long-term neuropsychiatric outcome in offspring whose mothers used cannabis during pregnancy for medical or recreational use, by any route and at any trimester, in comparison to offspring of women who abstained from cannabis use during pregnancy. All observational study designs were included in the analysis.
METHODS: A systematic
review and meta-analysis were performed according to the PRISMA and MOOSE guidelines. The data was extracted independently by two reviewers. The following offspring outcomes were of interest: attention-deficit/ hyperactivity disorder (ADHD), autism spectrum disorder (ASD), depression, anxiety, psychotic disorders, as well as cannabis and other substance use. Odds ratios (OR) and 95% confidence intervals (CI) were pooled for each neuropsychiatric outcome in the offspring of women exposed to cannabis during pregnancy compared with non-exposed. Data were pooled using random-effects models.
RESULTS: Eighteen eligible observational studies were included in the systematic
review, and seventeen were included in the final quantitative analysis, representing 534,445 participants. After adjusting for confounders, the pooled OR for ADHD was 1.13 (95% CI 1.01-1.26); for ASD, the pooled OR was 1.04 (95% CI 0.74-1.46); for psychotic symptoms, the pooled OR was 1.29 (95% CI 0.97-1.72); for anxiety, the pooled OR was 1.34 (95% CI 0.79-2.29); for depression, the pooled OR was 0.72 (95% CI 0.11-4.57); and for offspring\'s cannabis use the pooled OR was 1.20 (95% CI 1.01-1.42).
CONCLUSIONS: Prenatal cannabis exposure is not associated with an increased risk of ASD, psychotic symptoms, anxiety, or depression in offspring. However, it may slightly elevate the risk of ADHD and predispose offspring to cannabis consumption. Despite these findings, caution is warranted regarding cannabis use during pregnancy. Further research is imperative, especially given the increasing potency of cannabis in recent years.