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Am J Perinatol 2025; 42(09): 1206-1212
DOI: 10.1055/a-2480-3163
Original Article

Impact of Cannabis Legalization on Umbilical Cord Tissue Tetrahydrocannabinol Levels

Kimberly Spence
1   Division of Neonatal-Perinatal Medicine, SSM Cardinal Glennon Children's Hospital, Saint Louis, Missouri
2   Division of Neonatology, Department of Pediatrics, Saint Louis University, Saint Louis, Missouri
,
Sarah Milota
1   Division of Neonatal-Perinatal Medicine, SSM Cardinal Glennon Children's Hospital, Saint Louis, Missouri
2   Division of Neonatology, Department of Pediatrics, Saint Louis University, Saint Louis, Missouri
,
Paula Buchanan
2   Division of Neonatology, Department of Pediatrics, Saint Louis University, Saint Louis, Missouri
,
Nirja Acharya
1   Division of Neonatal-Perinatal Medicine, SSM Cardinal Glennon Children's Hospital, Saint Louis, Missouri
2   Division of Neonatology, Department of Pediatrics, Saint Louis University, Saint Louis, Missouri
,
Amit M. Mathur
1   Division of Neonatal-Perinatal Medicine, SSM Cardinal Glennon Children's Hospital, Saint Louis, Missouri
2   Division of Neonatology, Department of Pediatrics, Saint Louis University, Saint Louis, Missouri
› Author Affiliations
Funding None.
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Abstract

Objective

This study aimed to assess the impact of cannabis legalization on both qualitative and quantitative umbilical cord tissue tetrahydrocannabinol (THC) rates and concentrations as a proxy for fetal exposure.

Study Design

This is a retrospective, observational study of umbilical cord tissue THC levels in a single center, comparing THC exposure rates and concentration levels before and after cannabis legalization in the state of Illinois, Epoch 1 (October 1, 2018–June 30, 2019, pre-legalization) and Epoch 2 (July 1, 2019–August 31, 2021, post-legalization).

Results

A total of 811 umbilical cords were analyzed during epoch 1 and 2,170 during epoch 2. A higher percentage of umbilical cord tissue tested positive for THC in Epoch 2 compared with Epoch 1 (46.2 vs. 40.6%; p < 0.01). Mean THC levels were 51% higher in umbilical cord tissue in Epoch 2 versus Epoch 1 (6.2 ng/g vs. 4.1 ng/g; p < 0.001).

Conclusion

Legalization of recreational cannabis was associated with more fetuses exposed to THC and in higher concentrations.

Key Points

  • THC concentration can be measured in umbilical cord tissue after birth.

  • THC positivity in umbilical cord tissue can be used as a proxy for fetal exposure to cannabis.

  • Umbilical cord tissue THC concentration and rates of positivity increased with the legalization of cannabis.

Keywords

cannabis - umbilical cord - tetrahydrocannabinol

Note

This manuscript is original and has not been previously published except in abstract format for Pediatric Academic Society 2024.




Publication History

Received: 19 July 2024

Accepted: 20 November 2024

Accepted Manuscript online:
21 November 2024

Article published online:
24 December 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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