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Chapter 25 - Pre-natal Cannabis Exposure

Associations with Development and Behaviour

from Part VIII - Special Topics

Published online by Cambridge University Press:  12 May 2023

By
Sarah E. Paul ,
Cynthia E. Rogers  and
Ryan Bogdan
Edited by
Deepak Cyril D'Souza ,
David Castle  and
Sir Robin Murray
Deepak Cyril D'Souza
Affiliation:
Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine
David Castle
Affiliation:
University of Tasmania, Australia
Sir Robin Murray
Affiliation:
Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
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Summary

Rising rates of cannabis use during pregnancy and potential negative impacts on offspring health has generated concern. A small and equivocal, but rapidly developing, literature suggests that frequent and heavy pre-natal cannabis exposure (PCE) is associated with adverse neonatal outcomes (e.g., reduced birthweight and gestational age at birth) and may be associated with child psychopathology risk (e.g., externalizing behaviour and psychosis proneness, with less evidence linking PCE to internalizing problems and cognition). Non-human animal models suggest that PCE may causally influence these outcomes; however, in humans it remains unclear whether associations are independent of confounds (e.g., genetic and environmental liability). Mixed findings may be explained on the basis of small samples, limited phenotyping, stigma, confounds, and minimal consideration of timing and frequency of exposure. In particular, given that the central endocannabinoid type 1 receptor to which cannabis constituents bind are not known to be expressed in the foetus until the second half of the first trimester, it is possible that a lack of consideration of timing of exposure may explain null associations in some studies. Collectively, data highlight concerns that PCE is associated with adverse outcomes and suggest that cannabis use during pregnancy should be discouraged while more research is conducted.

Keywords

pre-natalcannabismarijuanachildneonatalbehaviouralcognitiveinternalizingexternalizingbirthweightpre-termendocannabinoid
Type
Chapter
Information
Marijuana and Madness , pp. 267 - 278
Publisher: Cambridge University Press
Print publication year: 2023

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References

Achenbach, T. M., McConaughy, S. H., and Howell, C. T. (1987). Child/adolescent behavioral and emotional problems: Implications of cross-informant correlations for situational specificity. Psychol Bull, 101, 213–232.CrossRefGoogle ScholarPubMed
Allen, A. M., Jung, A. M., Alexander, A. C., et al. (2020). Cannabis use and stressful life events during the perinatal period: Cross-sectional results from Pregnancy Risk Assessment Monitoring System (PRAMS) data, 2016. Addiction, 115, 1707–1716.Google Scholar
Alshaarawy, O., and Anthony, J. C. (2019). Are cannabis users less likely to gain weight? Results from a national 3-year prospective study. Int J Epidemiol, 48, 1695–1700.CrossRefGoogle ScholarPubMed
Antonelli, T., Tomasini, M. C., Tattoli, M., et al. (2005). Prenatal exposure to the CB1 receptor agonist WIN 55,212-2 causes learning disruption associated with impaired cortical NMDA receptor function and emotional reactivity changes in rat offspring. Cereb Cortex, 15, 2013–2020.Google Scholar
Bada, H. S., Bann, C. M., Bauer, C. R., et al. (2011). Preadolescent behavior problems after prenatal cocaine exposure: Relationship between teacher and caretaker ratings (Maternal Lifestyle Study). Neurotoxicol Teratol, 33, 78–87.CrossRefGoogle ScholarPubMed
Baer, R. J., Chambers, C. D., Ryckman, K. K., et al. (2019). Risk of preterm and early term birth by maternal drug use. J Perinatol, 39, 286–294.Google Scholar
Bara, A., Manduca, A., Bernabeu, A., et al. (2018). Sex-dependent effects of in utero cannabinoid exposure on cortical function. eLife, 7, e36234.Google Scholar
Basavarajappa, B. S., Nixon, R. A., and Arancio, O. (2009). Endocannabinoid system: Emerging role from neurodevelopment to neurodegeneration. Mini Rev Med Chem, 9, 448–462.Google Scholar
Bayrampour, H., Zahradnik, M., Lisonkova, S., et al. (2019). Women’s perspectives about cannabis use during pregnancy and the postpartum period: An integrative review. Prev Med, 119, 17–23.Google Scholar
Belbasis, L., Savvidou, M. D., Kanu, C., et al. (2016). Birth weight in relation to health and disease in later life: An umbrella review of systematic reviews and meta-analyses. BMC Med, 14, 147.Google Scholar
Berrendero, F., García-Gil, L., Hernández, M. L., et al. (1998). Localization of mRNA expression and activation of signal transduction mechanisms for cannabinoid receptor in rat brain during fetal development. Development, 125, 3179–3188.Google Scholar
Bolhuis, K., Kushner, S. A., Yalniz, S., et al. (2018). Maternal and paternal cannabis use during pregnancy and the risk of psychotic-like experiences in the offspring. Schizophr Res, 202, 322–327.Google Scholar
Brancato, A., Castelli, V., Lavanco, G., et al. (2020). In utero Δ9-tetrahydrocannabinol exposure confers vulnerability towards cognitive impairments and alcohol drinking in the adolescent offspring: Is there a role for neuropeptide Y? J Psychopharmacol (Oxf), 34, 663–679.CrossRefGoogle Scholar
Breit, K. R., Rodriguez, C. G., Lei, A., et al. (2020). Combined vapor exposure to THC and alcohol in pregnant rats: Maternal outcomes and pharmacokinetic effects. Neurotoxicol Teratol, 82, 106930.Google Scholar
Brents, L. K. (2017). Correlates and consequences of prenatal cannabis exposure (PCE): Identifying and characterizing vulnerable maternal populations and determining outcomes for exposed offspring. In: Preedy, V. R. (ed.), Handbook of Cannabis and Related Pathologies: Biology, Pharmacology, Diagnosis, and Treatment (pp. 160–170). London: Elsevier Inc.Google Scholar
Campolongo, P., Trezza, V., Cassano, T., et al. (2007). Perinatal exposure to delta-9-tetrahydrocannabinol causes enduring cognitive deficits associated with alteration of cortical gene expression and neurotransmission in rats. Addict Biol, 12, 485–495.Google Scholar
Carmody, D. P., Bennett, D. S., and Lewis, M. (2011). The effects of prenatal cocaine exposure and gender on inhibitory control and attention. Neurotoxicol Teratol, 33, 61–68.CrossRefGoogle ScholarPubMed
Cecil, C. A. M., Walton, E., Smith, R. G., et al. (2016). DNA methylation and substance-use risk: A prospective, genome-wide study spanning gestation to adolescence. Transl Psychiatry, 6, e976.Google Scholar
Chabarria, K. C., Racusin, D. A., Antony, K. M., et al. (2016). Marijuana use and its effects in pregnancy. Am J Obstet Gynecol, 215, 506.e1–506.e7.CrossRefGoogle ScholarPubMed
Chen, D. J., Gao, M., Gao, F. F., et al. (2017). Brain cannabinoid receptor 2: Expression, function and modulation. Acta Pharmacol Sin, 38, 312–316.Google Scholar
Compton, W. M., Han, B., Jones, C. M., et al. (2016). Marijuana use and use disorders in adults in the USA, 2002–14: Analysis of annual cross-sectional surveys. Lancet Psychiatry, 3, 954–964.CrossRefGoogle ScholarPubMed
Conner, S. N., Bedell, V., Lipsey, K., et al. (2016). Maternal marijuana use and adverse neonatal outcomes: A systematic review and meta-analysis. Obstet Gynecol, 128, 713–723.CrossRefGoogle ScholarPubMed
Cornelius, M. D., Taylor, P. M., Geva, D., et al. (1995). Prenatal tobacco and marijuana use among adolescents: Effects on offspring gestational age, growth, and morphology. Pediatrics, 95, 738–743.Google Scholar
Corsi, D. J., Walsh, L., Weiss, D., et al. (2019). Association between self-reported prenatal cannabis use and maternal, perinatal, and neonatal outcomes. JAMA, 322, 145–152.Google Scholar
Crume, T. L., Juhl, A. L., Brooks-Russell, A., et al. (2018). Cannabis use during the perinatal period in a state with legalized recreational and medical marijuana: The association between maternal characteristics, breastfeeding patterns, and neonatal outcomes. J Pediatr, 197, 90–96.Google Scholar
Day, N. L., Leech, S. L., and Goldschmidt, L. (2011). The effects of prenatal marijuana exposure on delinquent behaviors are mediated by measures of neurocognitive functioning. Neurotoxicol Teratol, 33, 129–136.Google Scholar
Day, N. L., and Richardson, G. A. (1991). Prenatal marijuana use: Epidemiology, methodologic issues, and infant outcome. Clin Perinatol, 18, 77–91.Google Scholar
Day, N. L., Richardson, G. A., Goldschmidt, L., et al. (1994). Effect of prenatal marijuana exposure on the cognitive development of offspring at age three. Neurotoxicol Teratol, 16, 169–175.Google Scholar
Day, N. L., Sambamoorthi, U., Taylor, P., et al. (1991). Prenatal marijuana use and neonatal outcome. Neurotoxicol Teratol, 13, 329–334.Google Scholar
Dinieri, J. A., Wang, X., Szutorisz, H., et al. (2011). Maternal cannabis use alters ventral striatal dopamine D2 gene regulation in the offspring. Biol Psychiatry, 70, 763–769.Google Scholar
El Marroun, H., Bolhuis, K., Franken, I. H. A., et al. (2019). Preconception and prenatal cannabis use and the risk of behavioural and emotional problems in the offspring; a multi-informant prospective longitudinal study. Int J Epidemiol, 48, 287–296.Google Scholar
El Marroun, H., Tiemeier, H., Jaddoe, V. W. V., et al. (2008). Demographic, emotional and social determinants of cannabis use in early pregnancy: The Generation R study. Drug Alcohol Depend, 98, 218–226.Google Scholar
El Marroun, H., Tiemeier, H., Steegers, E. A., et al. (2009). Intrauterine cannabis exposure affects fetal growth trajectories: The Generation R study. J Am Acad Child Adolesc Psychiatry, 48, 1173–1181.Google Scholar
ElSohly, M. A., Mehmedic, Z., Foster, S., et al. (2016). Changes in cannabis potency over the last 2 decades (1995–2014): Analysis of current data in the United States. Biol Psychiatry, 79, 613–619.Google Scholar
Fan, R. G., Portuguez, M. W., and Nunes, M. L. (2013). Cognition, behavior and social competence of preterm low birth weight children at school age. Clinics, 68, 915–921.Google Scholar
Fine, J. D., Moreau, A. L., Karcher, N. R., et al. (2019). Association of prenatal cannabis exposure with psychosis proneness among children in the Adolescent Brain Cognitive Development (ABCD) study. JAMA Psychiatry, 76, 762.Google Scholar
Frau, R., Miczan, V., Traccis, F., et al. (2019). Prenatal THC exposure produces a hyperdopaminergic phenotype rescued by pregnenolone. Nat Neurosci, 22, 1975–1985.CrossRefGoogle ScholarPubMed
Fried, P. A. (1995). The Ottawa Prenatal Prospective Study (OPPS): Methodological issues and findings – it’s easy to throw the baby out with the bath water. Life Sci, 56, 2159–2168.CrossRefGoogle ScholarPubMed
Fried, P. A., and O’Connell, C. M. (1987). A comparison of the effects of prenatal exposure to tobacco, alcohol, cannabis and caffeine on birth size and subsequent growth. Neurotoxicol Teratol, 9, 79–85.CrossRefGoogle ScholarPubMed
Fried, P. A., and Watkinson, B. (1988). 12- and 24-month neurobehavioural follow-up of children prenatally exposed to marihuana, cigarettes and alcohol. Neurotoxicol Teratol, 10, 305–313.CrossRefGoogle ScholarPubMed
Fried, P. A., Watkinson, B., Grant, A., et al. (1980). Changing patterns of soft drug use prior to and during pregnancy: A prospective study. Drug Alcohol Depend, 6, 323–343.Google Scholar
Fried, P. A., Watkinson, B., and Gray, R. (1992). A follow-up study of attentional behavior in 6-year-old children exposed prenatally to marihuana, cigarettes, and alcohol. Neurotoxicol Teratol, 14, 299–311.Google Scholar
Fried, P. A., Watkinson, B., and Gray, R. (1998). Differential effects on cognitive functioning in 9- to 12-year olds prenatally exposed to cigarettes and marihuana. Neurotoxicol Teratol, 20, 293–306.Google Scholar
Fried, P. A., Watkinson, B., and Gray, R. (2003). Differential effects on cognitive functioning in 13- to 16-year-olds prenatally exposed to cigarettes and marihuana. Neurotoxicol Teratol, 25, 427–436.CrossRefGoogle ScholarPubMed
Fried, P. A., Watkinson, B., and Willan, A. (1984). Marijuana use during pregnancy and decreased length of gestation. Am J Obstet Gynecol, 150, 23–27.Google Scholar
Gianutsos, G., and Abbatiello, E. R. (1972). The effect of pre-natal cannabis sativa on maze learning ability in the rat. Psychopharmacologia, 27, 117–122.CrossRefGoogle ScholarPubMed
Goldschmidt, L., Richardson, G. A., Cornelius, M. D., et al. (2004). Prenatal marijuana and alcohol exposure and academic achievement at age 10. Neurotoxicol Teratol, 26, 521–532.Google Scholar
Goldschmidt, L., Richardson, G. A., Willford, J., et al. (2008). Prenatal marijuana exposure and intelligence test performance at age 6. J Am Acad Child Adolesc Psychiatry, 47, 254–263.Google Scholar
Goldschmidt, L., Richardson, G. A., Willford, J. A., et al. (2012). School achievement in 14-year-old youths prenatally exposed to marijuana. Neurotoxicol Teratol, 34, 161–167.Google Scholar
Grant, K. S., Petroff, R., Isoherranen, N., et al. (2018). Cannabis use during pregnancy: Pharmacokinetics and effects on child development. Pharmacol Ther, 182, 133–151.Google Scholar
Graves, B. M., Johnson, T. J., Nishida, R. T., et al. (2020). Comprehensive characterization of mainstream marijuana and tobacco smoke. Sci Rep, 10, 1–12.Google Scholar
Gray, K. A., Day, N. L., Leech, S., et al. (2005). Prenatal marijuana exposure: Effect on child depressive symptoms at ten years of age. Neurotoxicol Teratol, 27, 439–448.Google Scholar
Grzeskowiak, L. E., Grieger, J. A., Andraweera, P., et al. (2020). The deleterious effects of cannabis during pregnancy on neonatal outcomes. Med J Aust, 212, 519–524.CrossRefGoogle ScholarPubMed
Gunn, J. K. L., Rosales, C. B., Center, K. E., et al. (2016). Prenatal exposure to cannabis and maternal and child health outcomes: A systematic review and meta-analysis. BMJ Open, 6, e009986.CrossRefGoogle ScholarPubMed
Holloway, Z. R., Hawkey, A. B., Torres, A. K., et al. (2020). Paternal cannabis extract exposure in rats: Preconception timing effects on neurodevelopmental behavior in offspring. NeuroToxicology, 81, 180–188.Google Scholar
Hutchings, D. E., Martin, B. R., Gamagaris, Z., et al. (1989). Plasma concentrations of delta-9-tetrahydrocannabinol in dams and fetuses following acute or multiple prenatal dosing in rats. Life Sci, 44, 697–701.CrossRefGoogle ScholarPubMed
Jaddoe, V. W. V., Mackenbach, J. P., Moll, H. A., et al. (2006). The Generation R study: Design and cohort profile. Eur J Epidemiol, 21, 475–484.Google Scholar
Kapur, B. M., and Aleksa, K. (2020). What the lab can and cannot do: clinical interpretation of drug testing results. Crit Rev Clin Lab Sci, 57, 548–585.CrossRefGoogle ScholarPubMed
Ko, J. Y., Farr, S. L., Tong, V. T., et al. (2015). Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age. Am J Obstet Gynecol, 213, 201.e1–201.e10.Google Scholar
Kooijman, M. N., Kruithof, C. J., van Duijn, C. M., et al. (2016). The Generation R study: Design and cohort update 2017. Eur J Epidemiol, 31, 1243–1264.Google Scholar
Leech, S. L., Richardson, G. A., Goldschmidt, L., et al. (1999). Prenatal substance exposure: Effects on attention and impulsivity of 6-year-olds. Neurotoxicol Teratol, 21, 109–118.CrossRefGoogle ScholarPubMed
Leemaqz, S. Y., Dekker, G. A., McCowan, L. M., et al. (2016). Maternal marijuana use has independent effects on risk for spontaneous preterm birth but not other common late pregnancy complications. Reprod Toxicol, 62, 77–86.Google Scholar
Levin, E. D., Hawkey, A. B., Hall, B. J., et al. (2019). Paternal THC exposure in rats causes long-lasting neurobehavioral effects in the offspring. Neurotoxicol Teratol, 74, 106806.Google Scholar
Maia, J., Midão, L., Cunha, S. C., et al. (2019). Effects of cannabis tetrahydrocannabinol on endocannabinoid homeostasis in human placenta. Arch Toxicol, 93, 649–658.Google Scholar
Manduca, A., Servadio, M., Melancia, F., et al. (2020). Sex-specific behavioural deficits induced at early life by prenatal exposure to the cannabinoid receptor agonist WIN55, 212-2 depend on mGlu5 receptor signalling. Br J Pharmacol, 177, 449–463.Google Scholar
Mereu, G., Fà, M., Ferraro, L., et al. (2003). Prenatal exposure to a cannabinoid agonist produces memory deficits linked to dysfunction in hippocampal long-term potentiation and glutamate release. Proc Natl Acad Sci USA, 100, 4915–4920.Google Scholar
Natale, B. V., Gustin, K. N., Lee, K., et al. (2020). Δ9-tetrahydrocannabinol exposure during rat pregnancy leads to symmetrical fetal growth restriction and labyrinth-specific vascular defects in the placenta. Sci Rep, 10, 1–15.Google Scholar
Niesink, R. J. M., and van Laar, M. W. (2013). Does cannabidiol protect against adverse psychological effects of THC? Front Psychiatry, 4, 130.CrossRefGoogle ScholarPubMed
O’Shea, M., and Mallet, P. E. (2005). Impaired learning in adulthood following neonatal Δ9-THC exposure. Behav Pharmacol, 16, 455–461.Google Scholar
Paul, S. E., Hatoum, A. S., Fine, J. D., et al. (2021). Associations between prenatal cannabis exposure and childhood outcomes: Results from the ABCD study. JAMA Psychiatry, 78, 64.Google Scholar
Porath, A. J., and Fried, P. A. (2005). Effects of prenatal cigarette and marijuana exposure on drug use among offspring. Neurotoxicol Teratol, 27, 267–277.Google Scholar
Richardson, G. A., Goldschmidt, L., and Willford, J. (2009). Continued effects of prenatal cocaine use: Preschool development. Neurotoxicol Teratol, 31, 325–333.Google Scholar
Richardson, G. A., Ryan, C., Willford, J., et al. (2002). Prenatal alcohol and marijuana exposure: Effects on neuropsychological outcomes at 10 years. Neurotoxicol Teratol, 24, 309–320.Google Scholar
Rose-Jacobs, R., Augustyn, M., Beeghly, M., et al. (2012). Intrauterine substance exposures and Wechsler Individual Achievement Test-II scores at 11 years of age. Vulnerable Child Youth Stud, 7, 186–197.Google Scholar
Rose-Jacobs, R., Soenksen, S., Appugliese, D. P., et al. (2011). Early adolescent executive functioning, intrauterine exposures and own drug use. Neurotoxicol Teratol, 33, 379–392.Google Scholar
Sagheddu, C., Traccis, F., Serra, V., et al. (2021). Mesolimbic dopamine dysregulation as a signature of information processing deficits imposed by prenatal THC exposure. Prog Neuropsychopharmacol Biol Psychiatry, 105, 110128.CrossRefGoogle ScholarPubMed
Silva, L., Zhao, N., Popp, S., et al. (2012). Prenatal tetrahydrocannabinol (THC) alters cognitive function and amphetamine response from weaning to adulthood in the rat. Neurotoxicol Teratol, 34, 63–71.Google Scholar
Singer, L. T., Nelson, S., Short, E., et al. (2008). Prenatal cocaine exposure: Drug and environmental effects at 9 years. J Pediatr, 153, 105–111.Google Scholar
Smith, A. M., Mioduszewski, O., Hatchard, T., et al. (2016). Prenatal marijuana exposure impacts executive functioning into young adulthood: An fMRI study. Neurotoxicol Teratol, 58, 53–59.Google Scholar
Sonon, K. E., Richardson, G. A., Cornelius, J. R., et al. (2015). Prenatal marijuana exposure predicts marijuana use in young adulthood. Neurotoxicol Teratol, 47, 10–15.CrossRefGoogle ScholarPubMed
Szutorisz, H., DiNieri, J. A., Sweet, E., et al. (2014). Parental THC exposure leads to compulsive heroin-seeking and altered striatal synaptic plasticity in the subsequent generation. Neuropsychopharmacology, 39, 1315–1323.Google Scholar
Szutorisz, H., Egervári, G., Sperry, J., et al. (2016). Cross-generational THC exposure alters the developmental sensitivity of ventral and dorsal striatal gene expression in male and female offspring. Neurotoxicol Teratol, 58, 107–114.Google Scholar
Torres, C. A., Medina-Kirchner, C., O’Malley, K. Y., et al. (2020). Totality of the evidence suggests prenatal cannabis exposure does not lead to cognitive impairments: A systematic and critical review. Front Psychol, 11, 816.CrossRefGoogle Scholar
Tortoriello, G., Morris, C. V., Alpar, A., et al. (2014). Miswiring the brain: Δ9-tetrahydrocannabinol disrupts cortical development by inducing an SCG10/stathmin-2 degradation pathway. EMBO J, 33, 668–685.Google Scholar
Trezza, V., Cuomo, V., and Vanderschuren, L. J. M. J. (2008). Cannabis and the developing brain: Insights from behavior. Eur J Pharmacol, 585, 441–452.Google Scholar
Volk, D. W., and Lewis, D. A. (2016). The role of endocannabinoid signaling in cortical inhibitory neuron dysfunction in schizophrenia. Biol Psychiatry, 79, 595–603.Google Scholar
Volkow, N. D., Fowler, J. S., Wang, G. J., et al. (2007). Dopamine in drug abuse and addiction: Results of imaging studies and treatment implications. Arch Neurol, 64, 1575–1579.Google Scholar
Volkow, N. D., Han, B., Compton, W. M., et al. (2019). Self-reported medical and nonmedical cannabis use among pregnant women in the United States. JAMA, 322, 167–169.Google Scholar
Wang, X., Dow-Edwards, D., Anderson, V., et al. (2004). In utero marijuana exposure associated with abnormal amygdala dopamine D2 gene expression in the human fetus. Biol Psychiatry, 56, 909–915.Google Scholar
Watson, C. T., Szutorisz, H., Garg, P., et al. (2015). Genome-wide DNA methylation profiling reveals epigenetic changes in the rat nucleus accumbens associated with cross-generational effects of adolescent THC exposure. Neuropsychopharmacology, 40, 2993–3005.CrossRefGoogle ScholarPubMed
Weimar, H. V., Wright, H. R., Warrick, C. R., et al. (2020). Long-term effects of maternal cannabis vapor exposure on emotional reactivity, social behavior, and behavioral flexibility in offspring. Neuropharmacology, 179, 108288.Google Scholar
Wu, C.-S., Jew, C. P., and Lu, H.-C. (2011). Lasting impacts of prenatal cannabis exposure and the role of endogenous cannabinoids in the developing brain. Future Neurol, 6, 459–480.CrossRefGoogle ScholarPubMed
Yao, J. L., He, Q. Z., Liu, M., et al. (2018). Effects of Δ(9)-tetrahydrocannabinol (THC) on human amniotic epithelial cell proliferation and migration. Toxicology, 394, 19–26.CrossRefGoogle Scholar
Young-Wolff, K. C., Adams, S. R., Padon, A., et al. (2021). Association of cannabis retailer proximity and density with cannabis use among pregnant women in Northern California after legalization of cannabis for recreational use. JAMA Netw Open, 4, e210694.Google Scholar
Young-Wolff, K. C., Sarovar, V., Tucker, L. Y., et al. (2020). Validity of self-reported cannabis use among pregnant females in Northern California. J Addict Med, 14, 287–292.CrossRefGoogle ScholarPubMed
Zammit, S., Thomas, K., Thompson, A., et al. (2009). Maternal tobacco, cannabis and alcohol use during pregnancy and risk of adolescent psychotic symptoms in offspring. Br J Psychiatry, 195, 294–300.CrossRefGoogle ScholarPubMed
Zurolo, E., Iyer, A. M., Spliet, W. G. M., et al. (2010). CB1 and CB2 cannabinoid receptor expression during development and in epileptogenic developmental pathologies. Neuroscience, 170, 28–41.Google Scholar

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