Although tobacco (TOB) and marijuana (MJ) are often co-used in pregnancy, little is known regarding the joint impact of MJ + TOB on offspring development, including the developing neuroendocrine stress system. Further, despite evidence for sex-specific impacts of prenatal exposures in preclinical models, the sex-specific impact of prenatal MJ + TOB exposure on offspring neuroendocrine regulation in humans is also unknown. In the current study, overall and sex-specific influences of MJ + TOB co-use on offspring cortisol regulation were investigated over the first postnatal month. 111 mother-infant pairs from a low-income, racially and ethnically diverse sample participated. Based on Timeline Followback data with biochemical verification, three groups were identified: (1) prenatal MJ + TOB, (2) TOB only, and (3) controls. Baseline cortisol and cortisol stress response were assessed at seven points over the first postnatal month using a handling paradigm in which saliva cortisol was assessed before, during, and following a standard neurobehavioral assessment (NICU Network Neurobehavioral Scale). A significant exposure group by offspring sex interaction emerged for baseline cortisol over the first postnatal month (p = .043); MJ + TOB-exposed males showed 35-36% attenuation of baseline cortisol levels vs. unexposed and TOB-exposed males (ps ≤ .003), while no effects of exposure emerged for females. Both MJ + TOB and TOB-exposed infants showed a 22% attenuation of cortisol stress response over the first postnatal month vs. unexposed infants (ps < .03), with evidence for sex-specific effects in exploratory analyses. Although results are preliminary, this is the first human study to investigate the impact of prenatal MJ exposure on infant cortisol and the first to reveal a sex-specific impact of prenatal MJ + TOB on cortisol regulation in humans. Future, larger-scale studies are needed to elucidate mechanisms and consequences of sex-specific effects of MJ and MJ + TOB on the developing neuroendocrine stress system.

中文翻译：

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产前烟草和大麻的共同使用：性别特异性对婴儿皮质醇应激反应的影响。


尽管烟草 (TOB) 和大麻 (MJ) 经常在怀孕期间同时使用，但关于 MJ + TOB 对后代发育（包括发育中的神经内分泌应激系统）的联合影响知之甚少。此外，尽管临床前模型中存在产前暴露对性别特异性影响的证据，但产前 MJ + TOB 暴露对人类后代神经内分泌调节的性别特异性影响也是未知的。在当前的研究中，在出生后第一个月内调查了 MJ + TOB 共同使用对后代皮质醇调节的整体和性别特异性影响。来自低收入、种族和民族多样化样本的 111 对母婴参与了研究。根据时间线随访数据和生化验证，确定了三组：(1) 产前 MJ + TOB，(2) 仅 TOB，以及 (3) 对照。使用处理范例在出生后第一个月的七个时间点评估基线皮质醇和皮质醇应激反应，其中在标准神经行为评估（NICU 网络神经行为量表）之前、期间和之后评估唾液皮质醇。在出生后第一个月内，通过后代性别相互作用出现了基线皮质醇的显着暴露组（p = .043）；与未暴露和 TOB 暴露的男性相比，MJ + TOB 暴露的男性的基线皮质醇水平下降了 35-36% (ps ≤ .003)，而女性没有出现暴露的影响。与未暴露的婴儿相比，MJ + TOB 和 TOB 暴露的婴儿在出生后第一个月的皮质醇应激反应均减弱了 22% (ps < .03)，探索性分析中有性别特异性影响的证据。 尽管结果是初步的，但这是第一项调查产前 MJ 暴露对婴儿皮质醇影响的人类研究，也是第一项揭示产前 MJ + TOB 对人类皮质醇调节的性别特异性影响的研究。未来需要更大规模的研究来阐明 MJ 和 MJ + TOB 对发育中的神经内分泌应激系统的性别特异性影响的机制和后果。