A population-based study of over 222,000 mother-child pairs in Australia found maternal cannabis use disorder was associated with a three-fold increased risk of autism spectrum disorder in offspring, with higher risk in male children.
Obstetricians, pediatricians, and pregnant individuals who use cannabis
3x higher ASD risk with maternal cannabis use disorder
What the researchers found
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.
Why it matters
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.
The numbers in context
222,534 mother-offspring pairs. Three-fold increased ASD risk with maternal CUD. Male offspring had higher risk than female. Study period: 2003-2005 births in New South Wales, Australia.
How the study worked
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.
What this study cannot tell us
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.
How to read the evidence
Large population-based cohort with linked administrative data, though limited by billing-code identification and potential unmeasured confounders.
When this study was published
2024 study using 2003-2005 birth data
The bigger picture
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.
Questions still open
- Is the association dose-dependent? Would less severe cannabis use (not meeting CUD criteria) show a similar risk? What biological mechanisms might explain the sex-specific effect?
Common questions
Can cannabis use during pregnancy increase autism risk?
Is the autism risk from prenatal cannabis different for boys and girls?
Read the original research
Exposure to maternal cannabis use disorder and risk of autism spectrum disorder in offspring: A data linkage cohort study.
Psychiatry research, 337, 115971
Citation
Tadesse, Abay Woday; Ayano, Getinet; Dachew, Berihun Assefa; Betts, Kim; Alati, Rosa. (2024). Exposure to maternal cannabis use disorder and risk of autism spectrum disorder in offspring: A data linkage cohort study.. Psychiatry research, 337, 115971. https://doi.org/10.1016/j.psychres.2024.115971
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