Parental alcohol and cannabis before and during pregnancy: a pilot study

SUMMARY
Alcohol is the most commonly used licit substance in pregnancy, and cannabis is the most commonly used illicit
substance in pregnancy. Approximately half of pregnant people who use cannabis also use alcohol, and one
third of pregnant people who used alcohol also used cannabis. Both substances are associated with adverse
outcomes among offspring, including preterm birth, small for gestational age offspring, and adverse
neurodevelopmental outcomes, including fetal alcohol spectrum disorders in alcohol-exposed offspring. There
is accumulating evidence that prenatal co-exposure to cannabis and alcohol confers greater risks to the
developing fetus than either exposure alone, although data are primarily from animal models. Further, there is
no evidence from pregnant populations of whether cannabis is used simultaneously with alcohol, and whether
cannabis substitutes or complements alcohol use over the highly dynamic time of pregnancy. Of additional
concern, there is accumulating evidence that paternal preconceptional exposure to cannabis and alcohol may
directly and indirectly increase the risk of adverse offspring outcomes.
The purpose of this developmental proposal is to gather information about alcohol and cannabis use before,
during and after pregnancy, for both the pregnant individual and the biologic father, to support the feasibly of a
larger cohort in the future. This proposal will elucidate distinct patterns of alcohol and cannabis use and co-use
that are necessary to power future studies, and the feasibility of enrolling and interviewing biologic fathers about
their own use. Our team includes a perinatal epidemiologist with research expertise in pregnancy cohort studies
and prenatal alcohol and cannabis use, a Maternal-Fetal-Medicine specialist with research expertise in alcohol,
cannabis and paternal exposures, and a psychiatrist who specializes in addiction during pregnancy. From San
Diego County, we will recruit 100 pregnant individuals who used cannabis and alcohol in the three months prior
to pregnancy, and their male partners. We will collect detailed information on alcohol and cannabis use and co-
use over the course of the pregnancy, using methods shown to be reliable in other pregnancy cohort studies.
The aims are to 1) Characterize the patterns of maternal alcohol and cannabis use before, during, and
after pregnancy, 2) Characterize the patterns of paternal alcohol and cannabis use before, during, and
after pregnancy, and 3). Model individual and joint trajectories of exposure for pregnant individuals and
their partners.
Success in this project will reveal the patterns of alcohol and cannabis use before, during and after pregnancy,
by the pregnant person and the biologic father. These data are critical to inform future studies of the direct and
indirect effects of parental use of alcohol and cannabis, and to inform intervention efforts and guide counseling.

Grant Number: 5R21AA031765-02
NIH Institute/Center: NIH
Principal Investigator: Gretchen Bandoli