Maternal perinatal cannabis use disorder and the risk of anxiety disorders in offspring: Insights from a longitudinal data-linkage cohort study.

BACKGROUND

Cannabis use is increasing among pregnant women, but its effects on child mental health remain poorly understood. This study investigates whether maternal cannabis use disorder (CUD) during pregnancy and the postnatal period increases offspring risk of anxiety disorders.

METHODS

We used linked administrative health data from New South Wales, Australia, covering 223,068 live births from January 2003 to December 2005. Maternal CUD and child anxiety disorders, including generalized anxiety disorder (GAD), phobic anxiety disorder (PAD), posttraumatic stress disorder (PTSD), separation and social anxiety disorders, were identified using ICD-10 codes. Generalized linear models (GLMs) with log-binomial regression estimated adjusted risk ratios (aRRs). Mediation and propensity score matching (PSM) analyses were also conducted to test the robustness of findings.

RESULTS

After adjusting for covariates, offspring prenatally exposed to maternal CUD had a 79% increased risk of any anxiety disorder [adjusted risk ratio (aRR) = 1.79 (95 % CI 1.40, 2.26)]; specifically PTSD [aRR = 2.46 (95 % CI 1.78, 3.33)], GAD [aRR = 2.18 (95 % CI 1.03, 4.60)], and CADs [aRR = 1.91 (95 % CI 1.05, 4.60)], compared to non-exposed offspring. Postnatal CUD exposure was also associated with an increased risk of any anxiety disorder [aRR = 2.02 (95 % CI 1.22, 3.14)] and PTSD [aRR = 2.97 (95 % CI 1.56, 5.17)]. These associations remained significant in mediation and PSM analyses.

CONCLUSION

Maternal CUD during pregnancy and the postnatal period is associated with elevated risks of anxiety disorders in offspring. These findings highlight the need for targeted interventions, including perinatal counselling, to reduce anxiety risks in offspring.