635 - Preliminary Findings From Neonatal Neurobehavioral (NNNS) Assessments Following High Potency Exposure to Cannabis in Utero

Publication Number: 4621.635

Sara K. Berkelhamer, University of Washington, Seattle, WA, United States; Kary Kublin, University of Washington School of Medicine, Seattle, WA, United States; Alyssa Guthrie, University of Washington School of Medicine, Seattle, WA, United States; Molly Kamicar, University of Washington School of Medicine, Seattle, WA, United States; Chelsea A. Bourmatnov, University of Washington School of Medicine, Bainbridge Island, WA, United States; Stephen Dager, University of Washington School of Medicine, Seattle, WA, United States; natalia Kleinhans, University of Washington, Seattle, WA, United States

Background: Growing use of cannabis in pregnancy paired with increasing potency of the product warrant thoughtful evaluation of the growth and developmental impacts of in utero exposure in a modern-day cohort. Beyond quickly outdated dosing, literature on the effects of gestational cannabis is limited by confounders including co-exposure to nicotine and substances of abuse. This study pairs comprehensive quantification of consumption during pregnancy with serial neuroimaging and developmental assessments in infants regularly exposed to gestational cannabis (absent nicotine or other substances).

Objective: Determine if in utero high potency cannabis exposure impacts behavioral state at 2 weeks as assessed on the Neonatal Neurobehavioral Scale (NNNS-II).

Design/Methods: 562 respondents were screened for participation with exclusion for late gestation (28%), concurrent alcohol, tobacco or drug use (13%), household tobacco use (2%), multiparity (1%), miscarriage (2%), non-local residence (2%), maternal medical, medications or hospitalization (2%), educational status (9%), non-pregnant status (2%) loss to contact (5%), and no longer interested (4%). 90 mothers have enrolled to date including 42 controls and 48 prenatal cannabis exposed (PCE). NNNS-II has been performed by one of two blinded and validated examiners with preliminary data available from 18 controls and 23 PCE. Results of NNNS-II were compiled for 8 summary scores and compared by paired T Test.

Results: Controls include 8 males and 9 females; PCE includes 8 males and 15 females. Average (±SD) corrected gestational age (CGA) at exam was 42.1 ± 0.8 and 42.5 ± 0.7 weeks for control and PCE, respectively. Comparable scoring for attention, regulation, nonoptimal reflexes and quality of movement was identified. Significant differences were noted in handling, arousal, tone and stress response with higher scores in PCE indicating a more active response to handling with greater arousal, paired with increased tone and stress response (Figure 1).

Conclusion(s): Our preliminary findings from behavioral assessments performed on control and PCE infants suggest differences in neurobehavioral state as early as 2 weeks CGA. Correlation of findings on the neonatal neurobehavioral assessment with developmental screening performed at 6 and 18 months would support developmental theories that argue for continuity and a biological basis of later child outcomes. Future evaluation will include additional infants, with plans for both latent profile analysis as well as analysis of the effect of variable timing and dose of PCE exposure.

NNNS Summary Scores at 42w CGA: Control versus Prenatal Cannabis Exposed
FIGURE 1 Prenatal Cannabis Exposure.pdfBlue bars represent controls, white bars represent infants with in utero prenatal cannabis exposure (PCE). * = p < 0,05.