In 141,570 children followed to age 11, maternal prenatal cannabis use was not associated with increased risk of ADHD or disruptive behavior disorders after adjusting for confounders.
Parents concerned about prenatal cannabis exposure effects, pediatricians, child psychiatrists, and prenatal health researchers.
What the researchers found
After adjusting for maternal sociodemographics, other substance use, and comorbidities, prenatal cannabis use showed no association with ADHD (aHR: 0.84) and an inverse association with DBD (aHR: 0.83). Frequency of use was also not associated with outcomes.
Why it matters
This is one of the largest and best-controlled studies on prenatal cannabis and child behavioral outcomes. The null finding challenges prior smaller studies that suggested links and provides reassurance on these specific outcomes.
The numbers in context
141,570 children, 117,130 pregnancies. 4.6% screened positive for cannabis. 7.7% offspring had ADHD, 6.8% had DBD. ADHD: aHR = 0.84 (95% CI: 0.70-1.01). DBD: aHR = 0.83 (95% CI: 0.71-0.97).
How the study worked
Population-based retrospective birth cohort of 141,570 children born 2011-2018 in Kaiser Permanente Northern California, with universal prenatal cannabis screening and follow-up to age 11 for ADHD and DBD diagnoses.
What this study cannot tell us
Observational study cannot prove absence of effect. Cannabis use is self-reported and may be underestimated. Cannot account for all confounders. Follow-up to age 11 may miss later-diagnosed cases.
How to read the evidence
Very large cohort with universal screening, long follow-up, and comprehensive confounder adjustment — among the strongest evidence available on this question.
When this study was published
Recent large-scale analysis providing the most comprehensive look at prenatal cannabis and child behavioral outcomes to date.
The bigger picture
Prenatal cannabis research often faces confounding challenges. This large, well-controlled study suggests that after properly accounting for maternal characteristics, cannabis itself may not increase ADHD/DBD risk — though other outcomes may still be affected.
Questions still open
- Why did prior smaller studies find associations that disappear in this larger, better-controlled study? Are there other neurodevelopmental outcomes that might still be affected?
Common questions
Does prenatal cannabis use cause ADHD?
Why is this different from earlier studies?
Read the original research
Prenatal Cannabis Use and Offspring Attention Deficit Hyperactivity Disorder and Disruptive Behavior Disorders: A Retrospective Cohort Study.
Journal of developmental and behavioral pediatrics : JDBP, 46(1), e25-e32
Citation
Young-Wolff, Kelly C; Kong, Kevin; Alexeeff, Stacey E; Croen, Lisa A; Oberman, Nina; Kirane, Harshal; Ansley, Deborah; Davignon, Meghan; Adams, Sara R; Avalos, Lyndsay A. (2025). Prenatal Cannabis Use and Offspring Attention Deficit Hyperactivity Disorder and Disruptive Behavior Disorders: A Retrospective Cohort Study.. Journal of developmental and behavioral pediatrics : JDBP, 46(1), e25-e32. https://doi.org/10.1097/DBP.0000000000001323
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