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Study breakdown

Children exposed to cannabis in the womb had higher BMI and body fat at age 10, but shared family factors may explain the link

Prospective CohortModerate evidence
The takeaway

Children exposed to maternal cannabis during pregnancy had higher BMI and altered body fat distribution at age 10, but similar patterns for paternal cannabis use suggest shared family lifestyle factors rather than direct fetal programming.

Obstetricians, pediatricians, parents, and researchers studying long-term effects of prenatal exposures.

Similar effects for maternal and paternal use suggest family factors, not fetal programming

What the researchers found

Children exposed to maternal cannabis during pregnancy had higher BMI (0.26 SDS), android/gynoid fat ratio (0.21 SDS), and fat-free mass index (0.24 SDS) at age 10. However, paternal substance use showed similar associations with child cardiometabolic outcomes, suggesting shared family-based social and lifestyle factors rather than direct intrauterine effects.

Why it matters

By comparing maternal and paternal exposure associations, this study provides an important reality check: what looks like a direct effect of prenatal cannabis exposure may actually reflect the environment children grow up in.

The numbers in context

4,792 families. Maternal cannabis exposure: +0.26 SDS BMI, +0.21 SDS android/gynoid fat ratio, +0.24 SDS fat-free mass index. Paternal associations were similar in magnitude.

How the study worked

Population-based prospective cohort of 4,792 mothers, fathers, and children. Parental substance use assessed by questionnaires during pregnancy. Child outcomes measured at age 10: BMI, body fat (DXA), blood pressure, lipids, glucose, and insulin.

What this study cannot tell us

Self-reported substance use. Paternal data used as negative control but may have direct biological effects (epigenetic). Cannot fully rule out direct fetal effects of cannabis. Loss to follow-up over 10 years.

How to read the evidence

Large prospective cohort with objective childhood measurements, strengthened by paternal exposure comparison.

When this study was published

Published in 2022 with outcome measurements at age 10.

The bigger picture

This study illustrates a critical methodological point in prenatal exposure research: when paternal exposures (which cannot directly affect the fetus) produce similar associations as maternal exposures, confounding by shared family factors is the most likely explanation.

Questions still open

  • Are the observed differences clinically meaningful? Could epigenetic paternal effects also contribute? Would controlling for diet, exercise, and socioeconomic factors fully explain the associations?

Common questions

Does cannabis during pregnancy cause childhood obesity?
Children exposed to maternal cannabis had higher BMI and body fat at age 10. However, paternal cannabis use showed similar associations, suggesting the link is more likely due to shared family lifestyle factors than direct effects on the developing fetus.
Why does paternal cannabis use matter for this research?
Paternal substance use serves as a negative control: since fathers' cannabis use cannot directly affect the fetus through the placenta, finding similar associations for both parents suggests that shared family environment and lifestyle, not direct fetal exposure, drives the observed outcomes.

Read the original research

Foetal tobacco and cannabis exposure, body fat and cardio-metabolic health in childhood.

Pediatric obesity, 17(3), e12863

Citation

Cajachagua-Torres, Kim N; El Marroun, Hanan; Reiss, Irwin K M; Santos, Susana; Jaddoe, Vincent W V. (2022). Foetal tobacco and cannabis exposure, body fat and cardio-metabolic health in childhood.. Pediatric obesity, 17(3), e12863. https://doi.org/10.1111/ijpo.12863

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