Large study found no link between prenatal cannabis use and child developmental delays

In a cohort of nearly 120,000 pregnancies, maternal cannabis use in early pregnancy was not associated with increased risk of speech/language disorders, motor delays, or global developmental delays in children through age 5.5 years.

Avalos, Lyndsay A et al.·JAMA network open·2024·highretrospective cohort
RTHC-05098Retrospective cohorthigh2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
retrospective cohort
Evidence
high
Sample
N=119,976

What This Study Found

No association was observed between maternal prenatal cannabis use and child speech/language disorders (HR 0.93, 95% CI 0.84-1.03), global developmental delays (HR 1.04, 95% CI 0.68-1.59), or motor delays (HR 0.86, 95% CI 0.69-1.06). No dose-response relationship was found.

Key Numbers

119,976 pregnancies among 106,240 individuals. 6,778 (5.6%) had documented cannabis use. Daily use: 618 (0.5%). Weekly: 722 (0.6%). Monthly or less: 1,617 (1.3%). No significant associations at any frequency.

How They Did This

Retrospective cohort of 119,976 children born 2015-2019 at Kaiser Permanente Northern California, followed to age 5.5 years. Prenatal cannabis use screened via self-report and urine toxicology at ~8-10 weeks gestation. Developmental delays identified from ICD-9/10 codes in electronic health records.

Why This Research Matters

While prenatal cannabis has been linked to neonatal outcomes like low birth weight, evidence on longer-term developmental effects has been limited and conflicting. This large study found no association with early developmental delays.

The Bigger Picture

This null finding contrasts with studies linking prenatal cannabis to ASD or ADHD, suggesting different developmental outcomes may have different risk profiles. The authors note this does not mean prenatal cannabis is safe, given known associations with other adverse outcomes.

What This Study Doesn't Tell Us

Cannabis use assessed only at entry to prenatal care (~8-10 weeks), missing later-pregnancy use patterns. Some developmental delays may not manifest until after age 5.5. Self-report likely underestimates use. EHR diagnosis codes may miss milder delays.

Questions This Raises

  • ?Would longer follow-up (through school age) reveal associations not apparent by age 5.5?
  • ?Do specific developmental domains show effects at later ages?

Trust & Context

Key Stat:
No association at any use frequency
Evidence Grade:
Large population-based cohort with objective screening and EHR follow-up provides strong evidence, though limited to early-pregnancy exposure assessment.
Study Age:
2024 study of Kaiser Permanente data from 2015-2021
Original Title:
Early Maternal Prenatal Cannabis Use and Child Developmental Delays.
Published In:
JAMA network open, 7(10), e2440295 (2024)
Database ID:
RTHC-05098

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study
What do these levels mean? →

Frequently Asked Questions

Does this mean cannabis is safe during pregnancy?

No. The authors emphasize that prenatal cannabis is associated with other adverse outcomes (low birth weight, preterm birth). This study only examined early developmental delays and found no link, but other risks remain.

How was cannabis use measured?

Through self-report and urine toxicology testing at entry to prenatal care (around 8-10 weeks gestation). This captures early pregnancy use but may miss use later in pregnancy.

Read More on RethinkTHC

Cite This Study

RTHC-05098·https://rethinkthc.com/research/RTHC-05098

APA

Avalos, Lyndsay A; Oberman, Nina; Alexeeff, Stacey E; Croen, Lisa A; Davignon, Meghan N; Adams, Sara R; Ansley, Deborah; Chambers, Christina D; Steuerle, Kristin; Young-Wolff, Kelly C. (2024). Early Maternal Prenatal Cannabis Use and Child Developmental Delays.. JAMA network open, 7(10), e2440295. https://doi.org/10.1001/jamanetworkopen.2024.40295

MLA

Avalos, Lyndsay A, et al. "Early Maternal Prenatal Cannabis Use and Child Developmental Delays.." JAMA network open, 2024. https://doi.org/10.1001/jamanetworkopen.2024.40295

RethinkTHC

RethinkTHC Research Database. "Early Maternal Prenatal Cannabis Use and Child Developmental..." RTHC-05098. Retrieved from https://rethinkthc.com/research/avalos-2024-early-maternal-prenatal-cannabis

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.