Parental cannabis and tobacco use during pregnancy and childhood hair cortisol concentrations

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Background: Fetal exposure to cannabis and tobacco during pregnancy leads to adverse fetal and childhood outcomes. We hypothesized that fetal exposure to cannabis and tobacco have persistent programming effects on hypothalamic pituitary adrenal (HPA) axis functioning in childhood. Therefore, we examined the associations of parental cannabis and tobacco use during pregnancy with childhood hair cortisol and cortisone concentrations at 6 years, as biomarkers of long-term HPA-axis functioning. Method: In a population-based prospective birth cohort among 2577 mothers and their children, information of parental cannabis and tobacco use was collected by questionnaires, and maternal urine samples were additionally analyzed to detect cannabis metabolite concentrations. Cortisol and cortisone were measured in hair samples at 6 years. Linear regression analysis with adjustment for several confounders was used to test our hypothesis. Results: As compared to non-exposed children, offspring exposed to cannabis during pregnancy (in combination with tobacco) had higher childhood cortisol concentrations (log-10 transformed difference 0.16, 95 % Confidence Interval 0.04 to 0.28). This association was not mediated by birth weight. No differences in cortisone concentrations among cannabis-exposed children were observed. Maternal tobacco use during pregnancy was not associated with childhood cortisol or cortisone concentrations. Further, paternal cannabis or tobacco use was not associated with childhood cortisol or cortisone concentrations. Conclusions: Our findings suggest that maternal cannabis use, combined with tobacco, during pregnancy is associated with alterations in offspring HPA-axis functioning. Further studies need to replicate these findings, and assess the causality and long-term consequences of these associations.

Original languageEnglish
Article number108751
JournalDrug and Alcohol Dependence
Publication statusPublished - 1 Aug 2021

Bibliographical note

Funding Information:
The general design of the Generation R Study was supported by Erasmus Medical Center , Erasmus University Rotterdam , the Netherlands, the Organization for Health Research and Development (ZonMw) and the Ministry of Health, Welfare and Sport . VWVJ was supported by a Consolidator Grant from the European Research Council [ ERC-2014-CoG-648916 ]. EFCvR and ELTvdA were supported by the Elisabeth Foundation , and EFCvR was supported by the Netherlands Organization of Scientific Research NWO [Vidi Grant Number 91716453 ]. HEM was supported by Stichting Volksbond Rotterdam , the Dutch Brain Foundation [De Hersenstichting, project number GH2016.2.01], the NARSAD Young Investigator Grant from the Brain & Behavior Research Foundation [grant number 27853 ], and the European Union's Horizon 2020 Research and Innovation Program [LifeCycle, grant agreement 733206]. KNCT was supported by Peruvian Scholarship [ 547-2018-SERVIR ]. The founding sources had no role in the study design, collection, analysis and interpretation of data, writing of the report, or in the decision to submit the paper for publication.

Publisher Copyright:
© 2021 The Author(s)

Research programs

  • EMC MM-04-54-08-A
  • EMC MM-01-54-01
  • EMC MM-03-54-04-A


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