Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan;20(1):e13187.
doi: 10.1111/ijpo.13187. Epub 2024 Dec 16.

Impact of prenatal exposure to delta 9-tetrahydrocannabinol and cannabidiol on birth size and postnatal growth trajectories

Brianna F Moore  1   2 , Noel T Mueller  1   2   3 , Wei Perng  1   2 , Katherine A Sauder  4 , Emily T Hébert  5 , Adrienne T Hoyt  5 , Erica M Wymore  3 , Kristen E Boyle  2   3 , Emily J Su  6 , Allison L B Shapiro  2   3 , Gregory Kinney  1 , Cristina Sempio  7 , Jost Klawitter  7 , Uwe Christians  7 , Dana Dabelea  1   2   3
Affiliations

Impact of prenatal exposure to delta 9-tetrahydrocannabinol and cannabidiol on birth size and postnatal growth trajectories

Brianna F Moore et al. Pediatr Obes. 2025 Jan.

Abstract

Background: Prenatal exposure to cannabis (or more specifically, delta 9-tetrahydrocannabinol [Δ9-THC]) has been consistently linked to low birthweight. Animal models further show that Δ9-THC is associated with rapid postnatal growth. Whether this association is modified by breastfeeding is unknown.

Methods: In this exploratory study, we followed 128 mother-child pairs through 3 years. Urinary Δ9-THC and cannabidiol (CBD) were measured mid-gestation. Generalized linear models estimated the associations between Δ9-THC and neonatal body composition. A mixed-effects model estimated the association between Δ9-THC and body mass index (BMI) z-score trajectories. Interaction was assessed by a three-way product term (Δ9-THC × breastmilk months × age).

Results: Fifteen children (12%) had Δ9-THC exposure; three had concomitant CBD exposure. Prenatal exposure to Δ9-THC alone was associated with lower fat mass (-95 g, 95% confidence interval [CI]: -174, -14) and neonatal adiposity (-2.1%; 95% CI: -4.2, -0.4) followed by rapid postnatal growth (0.42 increase in BMI z-score per square root year; 95% CI: 0.12, 0.72). Breastfeeding modified this association (p = 0.04), such that growth was similar for those breastfed for 5 months whereas a shorter duration of breastfeeding was associated with 1.1 higher BMI z-score at 3 years (95% CI: 0.21, 2.05).

Conclusions: Our study suggests that prenatal exposure to Δ9-THC may alter early-life growth. Breastfeeding may stabilize rapid postnatal growth, but the impact of lactational exposure requires further investigation.

Keywords: BMI; adiposity; breastfeeding; cannabidiol; cannabis; delta‐9‐tetrahydrocannabinol; foetal growth restriction; growth trajectory; postnatal weight gain.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
BMI z‐score trajectories among children with prenatal exposure to Δ9‐THC (n = 15) and children with no prenatal exposure to Δ9‐THC (n = 125). The rate of growth in BMI z‐score was more rapid among Δ9‐THC‐exposed offspring, as compared to unexposed offspring (0.42 per square root year; 95% CI: 0.12, 0.72; p < 0.01). Δ9‐THC, delta 9‐tetrahydrocannabinol; BMI, body mass index; CI, confidence interval.
FIGURE 2
FIGURE 2
BMI z‐score trajectories according to prenatal exposure to Δ9‐THC and breastfeeding. There was evidence of effect modification by breastfeeding (p‐value for Δ9‐THC × breastfed × age interaction = 0.04), such that Δ9‐THC did not appear to influence growth among those breastfed for 5 months whereas a shorter duration of breastfeeding was associated with 1.1 higher BMI z‐score at 36 months (95% CI: 0.21, 2.05). Δ9‐THC, delta 9‐tetrahydrocannabinol; BMI, body mass index; CI, confidence interval.
See this image and copyright information in PMC

References

    1. El Marroun H, Tiemeier H, Steegers EA, et al. Intrauterine cannabis exposure affects fetal growth trajectories: the generation R study. J Am Acad Child Adolesc Psychiatry. 2009;48(12):1173‐1181. - PubMed
    1. Hurd YL, Wang X, Anderson V, Beck O, Minkoff H, Dow‐Edwards D. Marijuana impairs growth in mid‐gestation fetuses. Neurotoxicol Teratol. 2005;27(2):221‐229. - PubMed
    1. Crume TL, Juhl AL, Brooks‐Russell A, Hall KE, Wymore E, Borgelt LM. Cannabis use during the perinatal period in a state with legalized recreational and medical marijuana: the association between maternal characteristics, breastfeeding patterns, and neonatal outcomes. J Pediatr. 2018;197:90‐96. - PubMed
    1. Michalski CA, Hung RJ, Seeto RA, et al. Association between maternal cannabis use and birth outcomes: an observational study. BMC Pregnancy Childbirth. 2020;20(1):771. - PMC - PubMed
    1. Grzeskowiak LE, Grieger JA, Andraweera P, et al. The deleterious effects of cannabis during pregnancy on neonatal outcomes. Med J Aust. 2020;212(11):519‐524. - PubMed