Maternal Cannabis Use Disorder Linked to Three-Fold Higher Autism Risk in Children

Children of mothers with cannabis use disorder had approximately three times the risk of being diagnosed with ASD compared to non-exposed children. Sensitivity analyses showed male offspring had a higher ASD risk associated with maternal CUD than female offspring.

Population-based retrospective cohort study using linked administrative health data from the New South Wales Perinatal Data Collection. Included 222,534 mother-offspring pairs from live births between January 2003 and December 2005. CUD and ASD identified via ICD-10-AM codes.

With cannabis use during pregnancy increasing alongside legalization, understanding its potential impact on neurodevelopment is critical. A three-fold risk increase is substantial and adds to growing evidence that cannabis exposure during fetal development may have lasting consequences.

This study joins a growing body of evidence linking prenatal cannabis exposure to neurodevelopmental outcomes. The sex-specific finding (higher risk in males) is consistent with the known male predominance of ASD and may reflect sex differences in vulnerability to cannabinoid exposure during brain development.

CUD is identified from billing codes, which captures only diagnosed disorder rather than all cannabis use during pregnancy. Cannot determine timing, dose, or frequency of use. Confounders like socioeconomic status, other substance use, and genetic factors may not be fully controlled. Observational design cannot prove causation.