Prenatal Cannabis Use and Child Diagnoses of Depressive and Anxiety Disorders

Authors

  • Kelly C. Young-Wolff Division of Research, Kaiser Permanente Northern California; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco; Department of Health Systems Science, Bernard J. Tyson Kaiser Permanente School of Medicine
  • Mahlet Shenkute Division of Research, Kaiser Permanente Northern California
  • Nina Oberman Division of Research, Kaiser Permanente Northern California
  • Stacey E. Alexeeff Division of Research, Kaiser Permanente Northern California
  • Lisa A. Croen Division of Research, Kaiser Permanente Northern California; Department of Health Systems Science, Bernard J. Tyson Kaiser Permanente School of Medicine
  • Jamie O. Lo Department of Obstetrics and Gynecology, Oregon Health and Science University; Division of Reproductive and Developmental Science, Oregon National Primate Research Center
  • Deborah Ansley The Permanente Medical Group, Regional Offices
  • Carley Castellanos The Permanente Medical Group, Regional Offices
  • Kathryn K. Ridout Division of Research, Kaiser Permanente Northern California; Department of Health Systems Science, Bernard J. Tyson Kaiser Permanente School of Medicine; Department of Psychiatry, Kaiser Permanente, Santa Rosa Medical Center
  • Matthew E. Hirschtritt Division of Research, Kaiser Permanente Northern California; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco; Department of Psychiatry, Kaiser Permanente, Oakland Medical Center
  • Lyndsay A. Avalos Division of Research, Kaiser Permanente Northern California; Department of Health Systems Science, Bernard J. Tyson Kaiser Permanente School of Medicine

Abstract

Objective: Prenatal cannabis use is associated with adverse pregnancy and neonatal outcomes, but research on its association with child anxiety and depressive disorders is limited. This study aimed to test the hypothesis that prenatal cannabis use is associated with child anxiety or depressive disorder diagnoses.  

Methods: Population-based retrospective birth cohort study of children (N=115,553) born between 1/1/2011-12/31-2017 to pregnant individuals (N= 97,376) universally screened for prenatal cannabis use. Cox proportional hazards regression models examined associations between cannabis use during early pregnancy (at ~8-10 weeks gestation based on self-reported use or a positive urine toxicology test for delta-9-tetrahydrocannabinol [THC]) and child anxiety and depressive disorders from ages 6 to 13 years based on diagnosis codes, adjusting for maternal sociodemographic and clinical characteristics.

Results: The median (IQR) age at pregnancy onset was 31 (6) years. Most pregnancies (61.4%) were to non-White individuals; 4.4% screened positive for any cannabis use; 3.7% had a positive toxicology test and 1.9% self-reported use. Overall, 9,230 children were diagnosed with an anxiety disorder at (median (IQR)) age of 8 (3) years and 1,224 with depressive disorder at median (IQR) age of 9 (3) years. Prenatal cannabis use was associated with lower risk of child anxiety disorders (aHR:0.84:95%CI: 0.75-0.95) which remained significant when defined by a toxicology test but not when defined by self-report. Maternal prenatal cannabis use was not associated with child depressive disorders (aHR:1.15:95%CI: 0.85-1.54).

Conclusions: Prenatal cannabis use during early pregnancy was not associated with an increased risk of offspring anxiety or depressive disorders.

Downloads

Additional Files

Published

2026-03-13

Issue

Section

Original Report