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A Longitudinal Study of Prenatal Marijuana Use: Effects on Sleep and Arousal at Age 3 Years

A Longitudinal Study of Prenatal Marijuana Use: Effects on Sleep and Arousal at Age 3 Years Abstract Objective: To test the hypothesis that sleep disruptions would be evident in 3-year-old children with a history of prenatal marijuana exposure. Design: A prospective study using stratified random sampling beginning in the fourth month of pregnancy. Marijuana and other substance use were assessed by interviews at multiple time points. Offspring were followed up through age 3 years with multidomain assessments at fixed time points, including electroencephalographic sleep studies in the newborn period and at age 3 years. Setting: Primary care, prenatal clinic at a university hospital. Subjects: The sample included 18 children with prenatal marijuana exposure (mean [±SD] age, 39.0±4.4 months) and 20 control children (mean [±SD] age, 39.7±4.4 months). The two groups were similar in relationship to maternal age, race, income, education, or maternal use of alcohol, nicotine, and other substances in the first trimester. Main Outcome Measure: Sleep variables from polysomnographic recordings at age 3 years. Results: Children with prenatal marijuana exposure showed more nocturnal arousals (mean [±SD], 8.2±5.3 vs 3.2±4.6; P<.003), more awake time after sleep onset (mean [±SD], 27.4±20.0 vs 13.7±12.4 min; P<.03),and lower sleep efficiency (mean [±SD], 91.0±3.8 vs 94.4±2.1; P<.03) than did control children. Conclusion: Prenatal marijuana exposure was associated with disturbed nocturnal sleep at age 3 years.(Arch Pediatr Adolesc Med. 1995;149:145-150) References 1. Clayton RR, Voss HL, Robbins C, Skinner WF. Gender differences in drug use: an epidemiological perspective . In: Ray B, Braude M, eds. Women and Drugs: A New Era for Research . Rockville, Md: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse; 1986;65:80-99. 2. Fried PA, Makin JE. Neonatal behavioral correlates of prenatal exposure to marijuana, cigarettes and alcohol in a low risk population . Neurotoxicol Teratol . 1987;9:1-7.Crossref 3. Fried PA, Watkinson B. 36- and 48-month neurobehavioral follow-up of children prenatally exposed to marijuana, cigarettes and alcohol . J Dev Behav Pediatr . 1990;11:49-58.Crossref 4. O'Connell CM, Fried PA. Prenatal exposure to cannabis: a preliminary report of postnatal consequences in school-age children . Neurotoxicol Teratol . 1991; 13:631-639.Crossref 5. Day NL, Richardson GA, Goldschmidt L, et al. The effect of prenatal marijuana exposure on the cognitive development of offspring at age three . Neurotoxicol Teratol . 1994;16:169-175.Crossref 6. Tennes K, Avitable N, Blackard C, et al. Marijuana: prenatal and postnatal exposure in the human . In: Pinkert TM, ed. Consequences of Maternal Drug Abuse . Rockville, Md: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse; 1985; 59:48-60. 7. Hayes JS, Dreher MC, Nugent JK. Newborn outcomes with maternal marijuana use in Jamaican women . Pediatr Nurs . 1988;14:107-110. 8. Richardson GA, Day NL, Taylor PM. The effect of prenatal alcohol, marijuana and tobacco exposure on neonatal behavior . Infant Behav Dev . 1989;12:199-209.Crossref 9. Streissguth AP, Barr HM, Sampson PD, Darby BL, Martin DC. IQ at age 4 in relation to maternal alcohol use and smoking during pregnancy . Dev Psychol . 1989;25:3-11.Crossref 10. Lester BM, Dreher M. Effects of marijuana use during pregnancy on newborn cry . Child Dev . 1989;60:765-771.Crossref 11. Scher MS, Richardson GA, Coble PA, Day NL, Stoffer DS. The effects of prenatal alcohol and marijuana exposure: disturbances in neonatal sleep cycling and arousal . Pediatr Res . 1988;24:101-105.Crossref 12. Day N, Richardson G, Geva D, Robles N. Alcohol, marijuana and tobacco: the effects of prenatal exposure on offspring growth and morphology at age six. Alcohol Clin Exp Res. In press. 13. Gold MS. Marijuana . New York, NY: Plenum Publishing Corp; 1989. 14. Hawks RL, Chiang CN. Examples of specific drug assays . In: Hawks RL, Chiang CN, eds. Urine Testing for Drugs of Abuse . Rockville, Md: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse; 1986;73:84-112. 15. Julien RM. A Primer of Drug Action . 5th ed. New York, NY: WH Freeman & Co; 1988. 16. Day N, Robles N. Methodological issues in the measurement of substance use . Ann N Y Acad Sci . 1989;562:8-13.Crossref 17. Day N, Sambamoorthi U, Taylor P, et al. Prenatal marijuana use and neonatal outcome . Neurotoxicol Teratol . 1991;13:329-334.Crossref 18. Rechtschaffen A, Kales A, eds. A Manual of Standardized Terminology, Techniques and Scoring System for Sleep of Human Subjects . Bethesda, Md: US Dept of Health, Education, and Welfare; 1968. 19. Dahl RE, Puig-Antich J, Ryan ND, Cunningham S, Nelson B, Klepper T. EEG sleep in adolescent depression . J Affect Disord . 1990;19:63-75.Crossref 20. Dahl RE, Ryan ND, Birmaher B, et al. Electroencephalographic sleep measures in prepubertal depression . Psychiatry Res . 1991;38:201-214.Crossref 21. Anders T, Emde T, Parmelee AH, eds. A Manual of Standardized Terminology, Techniques, and Criteria for Scoring of States of Sleep and Wakefulness in Newborn Infants . Los Angeles, Calif: UCLA Brain Information Service/Brain Research Institute Publication Office; 1971. 22. Kales A, Hamley J, Rickles W. Effects of marijuana administration and withdrawal in chronic users and naive subjects . Psychophysiology . 1972:9:92. 23. Adams PM, Barratt ES. Effect of chronic marijuana administration on stages of primate sleep-wakefulness . Biol Psychiatry . 1975;10:315-322. 24. Pranikoff K, Karacan I, Larson EA, Williams RL, Thornby JI, Hursch CJ. Effects of marijuana smoking on the sleep EEG . J Fla Med Assoc . 1973;60:28-31. 25. Barratt ES, Beaver W, White R, Blakeney P, Adams P. The effects of the chronic use of marijuana on sleep and perceptual-motor performance in humans . In: Lewis MF, ed. Current Research in Marijuana . New York: New York Academic Press; 1972:163-193. 26. Masur J, Khazan N. Induction by Cannabis sativa (marijuana) of rhythmic spike discharges overriding REM sleep electrocorticogram in the rat . Life Sci . 1970; 9( (pt 1) ):1275-1280.Crossref 27. Pirch JH, Cohn RA, Barnes PR, Barratt ES. Effects of acute and chronic administration of marijuana extract on the rat electrocorticogram . Neuropharmacology . 1972;11:231-240.Crossref 28. Wallach MB, Gershon S. The effects of Δ8-THC on the electroencephalogram (EEG), reticular multiple unit activity (RNA) and sleep of cats . Eur J Pharmacol . 1973;24:172-178.Crossref 29. Carskadon MA, Brown ED, Dement WC. Sleep fragmentation in the elderly: relationship to daytime sleep tendency . Neurobiol Aging . 1982;3:321-327.Crossref 30. Stepanski E, Lamphere J, Badia P, Zorick F, Roth T. Sleep fragmentation and daytime sleepiness . Sleep . 1984;7:18-26. 31. Dahl RE, Pelham WE, Wierson M. The role of sleep disturbances in attention deficit disorder symptoms: a case study . J Pediatr Psychol . 1991;16:229-239.Crossref 32. Dahl RE. Child and adolescent sleep disorders . In: Kaufman DM, Soloman GE, Pfeffer CR, eds. Child and Adolescent Neurology for Psychiatrists . Baltimore, Md: Williams & Wilkins; 1992:169-194. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Pediatrics & Adolescent Medicine American Medical Association

A Longitudinal Study of Prenatal Marijuana Use: Effects on Sleep and Arousal at Age 3 Years

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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
1072-4710
eISSN
1538-3628
DOI
10.1001/archpedi.1995.02170140027004
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Abstract

Abstract Objective: To test the hypothesis that sleep disruptions would be evident in 3-year-old children with a history of prenatal marijuana exposure. Design: A prospective study using stratified random sampling beginning in the fourth month of pregnancy. Marijuana and other substance use were assessed by interviews at multiple time points. Offspring were followed up through age 3 years with multidomain assessments at fixed time points, including electroencephalographic sleep studies in the newborn period and at age 3 years. Setting: Primary care, prenatal clinic at a university hospital. Subjects: The sample included 18 children with prenatal marijuana exposure (mean [±SD] age, 39.0±4.4 months) and 20 control children (mean [±SD] age, 39.7±4.4 months). The two groups were similar in relationship to maternal age, race, income, education, or maternal use of alcohol, nicotine, and other substances in the first trimester. Main Outcome Measure: Sleep variables from polysomnographic recordings at age 3 years. Results: Children with prenatal marijuana exposure showed more nocturnal arousals (mean [±SD], 8.2±5.3 vs 3.2±4.6; P<.003), more awake time after sleep onset (mean [±SD], 27.4±20.0 vs 13.7±12.4 min; P<.03),and lower sleep efficiency (mean [±SD], 91.0±3.8 vs 94.4±2.1; P<.03) than did control children. Conclusion: Prenatal marijuana exposure was associated with disturbed nocturnal sleep at age 3 years.(Arch Pediatr Adolesc Med. 1995;149:145-150) References 1. Clayton RR, Voss HL, Robbins C, Skinner WF. Gender differences in drug use: an epidemiological perspective . In: Ray B, Braude M, eds. Women and Drugs: A New Era for Research . Rockville, Md: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse; 1986;65:80-99. 2. Fried PA, Makin JE. Neonatal behavioral correlates of prenatal exposure to marijuana, cigarettes and alcohol in a low risk population . Neurotoxicol Teratol . 1987;9:1-7.Crossref 3. Fried PA, Watkinson B. 36- and 48-month neurobehavioral follow-up of children prenatally exposed to marijuana, cigarettes and alcohol . J Dev Behav Pediatr . 1990;11:49-58.Crossref 4. O'Connell CM, Fried PA. Prenatal exposure to cannabis: a preliminary report of postnatal consequences in school-age children . Neurotoxicol Teratol . 1991; 13:631-639.Crossref 5. Day NL, Richardson GA, Goldschmidt L, et al. The effect of prenatal marijuana exposure on the cognitive development of offspring at age three . Neurotoxicol Teratol . 1994;16:169-175.Crossref 6. Tennes K, Avitable N, Blackard C, et al. Marijuana: prenatal and postnatal exposure in the human . In: Pinkert TM, ed. Consequences of Maternal Drug Abuse . Rockville, Md: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse; 1985; 59:48-60. 7. Hayes JS, Dreher MC, Nugent JK. Newborn outcomes with maternal marijuana use in Jamaican women . Pediatr Nurs . 1988;14:107-110. 8. Richardson GA, Day NL, Taylor PM. The effect of prenatal alcohol, marijuana and tobacco exposure on neonatal behavior . Infant Behav Dev . 1989;12:199-209.Crossref 9. Streissguth AP, Barr HM, Sampson PD, Darby BL, Martin DC. IQ at age 4 in relation to maternal alcohol use and smoking during pregnancy . Dev Psychol . 1989;25:3-11.Crossref 10. Lester BM, Dreher M. Effects of marijuana use during pregnancy on newborn cry . Child Dev . 1989;60:765-771.Crossref 11. Scher MS, Richardson GA, Coble PA, Day NL, Stoffer DS. The effects of prenatal alcohol and marijuana exposure: disturbances in neonatal sleep cycling and arousal . Pediatr Res . 1988;24:101-105.Crossref 12. Day N, Richardson G, Geva D, Robles N. Alcohol, marijuana and tobacco: the effects of prenatal exposure on offspring growth and morphology at age six. Alcohol Clin Exp Res. In press. 13. Gold MS. Marijuana . New York, NY: Plenum Publishing Corp; 1989. 14. Hawks RL, Chiang CN. Examples of specific drug assays . In: Hawks RL, Chiang CN, eds. Urine Testing for Drugs of Abuse . Rockville, Md: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse; 1986;73:84-112. 15. Julien RM. A Primer of Drug Action . 5th ed. New York, NY: WH Freeman & Co; 1988. 16. Day N, Robles N. Methodological issues in the measurement of substance use . Ann N Y Acad Sci . 1989;562:8-13.Crossref 17. Day N, Sambamoorthi U, Taylor P, et al. Prenatal marijuana use and neonatal outcome . Neurotoxicol Teratol . 1991;13:329-334.Crossref 18. Rechtschaffen A, Kales A, eds. A Manual of Standardized Terminology, Techniques and Scoring System for Sleep of Human Subjects . Bethesda, Md: US Dept of Health, Education, and Welfare; 1968. 19. Dahl RE, Puig-Antich J, Ryan ND, Cunningham S, Nelson B, Klepper T. EEG sleep in adolescent depression . J Affect Disord . 1990;19:63-75.Crossref 20. Dahl RE, Ryan ND, Birmaher B, et al. Electroencephalographic sleep measures in prepubertal depression . Psychiatry Res . 1991;38:201-214.Crossref 21. Anders T, Emde T, Parmelee AH, eds. A Manual of Standardized Terminology, Techniques, and Criteria for Scoring of States of Sleep and Wakefulness in Newborn Infants . Los Angeles, Calif: UCLA Brain Information Service/Brain Research Institute Publication Office; 1971. 22. Kales A, Hamley J, Rickles W. Effects of marijuana administration and withdrawal in chronic users and naive subjects . Psychophysiology . 1972:9:92. 23. Adams PM, Barratt ES. Effect of chronic marijuana administration on stages of primate sleep-wakefulness . Biol Psychiatry . 1975;10:315-322. 24. Pranikoff K, Karacan I, Larson EA, Williams RL, Thornby JI, Hursch CJ. Effects of marijuana smoking on the sleep EEG . J Fla Med Assoc . 1973;60:28-31. 25. Barratt ES, Beaver W, White R, Blakeney P, Adams P. The effects of the chronic use of marijuana on sleep and perceptual-motor performance in humans . In: Lewis MF, ed. Current Research in Marijuana . New York: New York Academic Press; 1972:163-193. 26. Masur J, Khazan N. Induction by Cannabis sativa (marijuana) of rhythmic spike discharges overriding REM sleep electrocorticogram in the rat . Life Sci . 1970; 9( (pt 1) ):1275-1280.Crossref 27. Pirch JH, Cohn RA, Barnes PR, Barratt ES. Effects of acute and chronic administration of marijuana extract on the rat electrocorticogram . Neuropharmacology . 1972;11:231-240.Crossref 28. Wallach MB, Gershon S. The effects of Δ8-THC on the electroencephalogram (EEG), reticular multiple unit activity (RNA) and sleep of cats . Eur J Pharmacol . 1973;24:172-178.Crossref 29. Carskadon MA, Brown ED, Dement WC. Sleep fragmentation in the elderly: relationship to daytime sleep tendency . Neurobiol Aging . 1982;3:321-327.Crossref 30. Stepanski E, Lamphere J, Badia P, Zorick F, Roth T. Sleep fragmentation and daytime sleepiness . Sleep . 1984;7:18-26. 31. Dahl RE, Pelham WE, Wierson M. The role of sleep disturbances in attention deficit disorder symptoms: a case study . J Pediatr Psychol . 1991;16:229-239.Crossref 32. Dahl RE. Child and adolescent sleep disorders . In: Kaufman DM, Soloman GE, Pfeffer CR, eds. Child and Adolescent Neurology for Psychiatrists . Baltimore, Md: Williams & Wilkins; 1992:169-194.

Journal

Archives of Pediatrics & Adolescent MedicineAmerican Medical Association

Published: Feb 1, 1995

References