{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T05:08:09Z","timestamp":1792732089541,"version":"4.5.0"},"reference-count":64,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To estimate associations of more than minimal prenatal nicotine, alcohol, cannabis, and opioid exposures with gestational age, birth weight, and birth weight for gestational age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Data were drawn from the HEALthy Brain and Child Development (HBCD) Study, a multisite, longitudinal study in the United States. Predefined recruitment thresholds for each substance were assessed using maternal self-report, maternal toxicology results, and newborn substance exposure-related diagnoses. Birth outcomes included gestational age at delivery (weeks), birth weight (grams), and birth weight for gestational age (centiles). Mean differences and risk ratios for the associations between substance exposure and birth outcomes were estimated using multilevel mixed-effect linear regression or multilevel mixed-effect Poisson regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 660 mother-infant dyads, 17% (n\u2009=\u2009115) of participants met recruitment thresholds for prenatal cannabis, 15% for nicotine (n\u2009=\u2009102), 13% for alcohol (n\u2009=\u200986), and 5% for opioids (n\u2009=\u200932). In adjusted models, prenatal cannabis and opioid exposures were each associated with lower birth weight (cannabis: \u2212272.2 [95% CI \u2212444.6 to \u221299.8] g; opioids: \u2212295.4 [95% CI \u2212574.9 to \u221215.9] g) and birth weight centiles (cannabis: \u22128.2 [95% CI \u221215.3 to \u22121.1] centiles; opioids: \u221214.4 [95% CI \u221225.5, \u22123.4] centiles), although the results were sensitive to model specifications. Prenatal nicotine and alcohol estimates were in similar directions but not statistically significant. No significant associations between exposures and gestational age at delivery were detected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In this initial HBCD Study data release, more than minimal exposure to cannabis and opioids was associated with smaller birth size, adding evidence to an inconsistent literature. Future studies from HBCD can more deeply interrogate timing and dose of each substance and expand to childhood outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2025-074604","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:03:02Z","timestamp":1779753782000},"source":"Crossref","is-referenced-by-count":1,"title":["Prenatal Substance Exposure and Birth Weight: Findings From the HEALthy Brain and Child Development Study"],"prefix":"10.1542","volume":"157","author":[{"given":"Gretchen","family":"Bandoli","sequence":"first","affiliation":[{"name":"1Department of Pediatrics, University of California San Diego, La Jolla, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Psaras","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, University of California San Diego, La Jolla, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludmila N.","family":"Bakhireva","sequence":"additional","affiliation":[{"name":"2The Substance Use Research and Education (SURE) Center, University of New Mexico College of Pharmacy, Albuquerque, New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather H.","family":"Burris","sequence":"additional","affiliation":[{"name":"3Children\u2019s Hospital of Philadelphia and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Ciciolla","sequence":"additional","affiliation":[{"name":"4Department of Psychology at Oklahoma State University, Stillwater, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire D.","family":"Coles","sequence":"additional","affiliation":[{"name":"5Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara B.","family":"DeMauro","sequence":"additional","affiliation":[{"name":"3Children\u2019s Hospital of Philadelphia and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah S.","family":"Osmundson","sequence":"additional","affiliation":[{"name":"6Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Merhar","sequence":"additional","affiliation":[{"name":"7Cincinnati Children\u2019s Hospital and Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Smith","sequence":"additional","affiliation":[{"name":"8The Lundquist Institute at Harbor-UCLA Medical Center, University of California Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Acheson","sequence":"additional","affiliation":[{"name":"9Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Bogdan","sequence":"additional","affiliation":[{"name":"10Department of Psychological and Brain Sciences, Washington University in Saint Louis, Saint Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie M.","family":"Croff","sequence":"additional","affiliation":[{"name":"11Department of Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie E.","family":"Cutting","sequence":"additional","affiliation":[{"name":"12Peabody College of Education and Human Development, Vanderbilt University, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin P.","family":"Conway","sequence":"additional","affiliation":[{"name":"13Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Daniele","family":"Fallin","sequence":"additional","affiliation":[{"name":"14Rollins School of Public Health, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Gao","sequence":"additional","affiliation":[{"name":"15Department of Biomedical Sciences and Imaging, Cedars Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugh","family":"Garavan","sequence":"additional","affiliation":[{"name":"16Department of Psychiatry, University of Vermont, Burlington, Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Gregory","sequence":"additional","affiliation":[{"name":"17Department Obstetrics and Gynecology, Cedars Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly K.","family":"Gurka","sequence":"additional","affiliation":[{"name":"18Department of Epidemiology, University of Florida, Gainesville, Florida"},{"name":"19Current affiliation: Department of Pediatrics, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Gurka","sequence":"additional","affiliation":[{"name":"20Department of Biostatistics, University of Florida, Gainesville, Florida"},{"name":"21Current affiliation: Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly L.","family":"Horan","sequence":"additional","affiliation":[{"name":"22Department of Obstetrics and Gynecology, Division of Global and Rural Women\u2019s Health, The University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katia D.","family":"Howlett","sequence":"additional","affiliation":[{"name":"23National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany R.","family":"Howell","sequence":"additional","affiliation":[{"name":"24Fralin Biomedical Research Institute at Virginia Tech Carilion, Virginia Tech, Roanoke, Virginia"},{"name":"25Department of Human Development and Family Science, Virginia Tech, Blacksburg, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Huang","sequence":"additional","affiliation":[{"name":"26Department of Radiology, Children\u2019s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Kable","sequence":"additional","affiliation":[{"name":"5Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly H.","family":"LeBlanc","sequence":"additional","affiliation":[{"name":"23National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janosch","family":"Linkersd\u00f6rfer","sequence":"additional","affiliation":[{"name":"27J. Craig Venter Institute, La Jolla, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla B.","family":"Marienfeld","sequence":"additional","affiliation":[{"name":"28Department of Psychiatry, University of California San Diego, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine M.","family":"McKelvey","sequence":"additional","affiliation":[{"name":"29Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda S.","family":"Morris","sequence":"additional","affiliation":[{"name":"30Department of Psychology, Oklahoma State University, Tulsa, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiawei","family":"Ou","sequence":"additional","affiliation":[{"name":"31Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myriam","family":"Peralta-Carcelen","sequence":"additional","affiliation":[{"name":"32Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2","family":"Pini","sequence":"additional","affiliation":[{"name":"33Department of Psychiatry, Columbia University Irving Medical Center, New York, New York"},{"name":"34Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra S.","family":"Potter","sequence":"additional","affiliation":[{"name":"35Department of Psychiatry, University of Vermont, Burlington, Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia E.","family":"Rogers","sequence":"additional","affiliation":[{"name":"36Departments of Psychiatry and Pediatrics, Washington University, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elinor L.","family":"Sullivan","sequence":"additional","affiliation":[{"name":"37Department of Psychiatry, Steven J. Sharp Center for Mental Health Innovation, Oregon Health & Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Sun","sequence":"additional","affiliation":[{"name":"38Lasso Informatics, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley K.","family":"Thompson","sequence":"additional","affiliation":[{"name":"39Center for Population Neuroscience and Genetics, Laureate Institute for Brain Research, Tulsa, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moriah E.","family":"Thomason","sequence":"additional","affiliation":[{"name":"40Department of Child and Adolescent Psychiatry, New York University Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather E.","family":"Volk","sequence":"additional","affiliation":[{"name":"41Department of Mental Health, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylia","family":"Wilson","sequence":"additional","affiliation":[{"name":"42Institute of Child Development, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra E.","family":"Zgierska","sequence":"additional","affiliation":[{"name":"43Departments of Family and Community Medicine, Anesthesiology and Perioperative Medicine, and Public Health Sciences, College of Medicine, Penn State, Hershey, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Zink","sequence":"additional","affiliation":[{"name":"38Lasso Informatics, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Smyser","sequence":"additional","affiliation":[{"name":"44Departments of Neurology, Pediatrics, Radiology, and Psychiatry, Washington University in St. Louis, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles A.","family":"Nelson","sequence":"additional","affiliation":[{"name":"45Department of Pediatrics, Harvard Medical School and Boston Children\u2019s Hospital, Cambridge, Massachusetts"},{"name":"46Harvard Graduate School of Education, Harvard University, Cambridge, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina D.","family":"Chambers","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, University of California San Diego, La Jolla, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"2026101508370551200_r1","article-title":"2020 NSDUH detailed tables","author":"Substance Abuse and Mental Health Services 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approach","volume":"71","author":"Gurka","year":"2025","journal-title":"Dev Cogn Neurosci."},{"key":"2026101508370551200_r5","doi-asserted-by":"crossref","first-page":"101441","DOI":"10.1016\/j.dcn.2024.101441","article-title":"An introduction to the HEALthy Brain and Child Development Study (HBCD) study","volume":"69","author":"Nelson","year":"2024","journal-title":"Dev Cogn Neurosci."},{"issue":"4","key":"2026101508370551200_r6","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.ajog.2022.05.056","article-title":"Impact of cannabinoids on pregnancy, reproductive health and offspring outcomes","volume":"227","author":"Lo","year":"2022","journal-title":"Am J Obstet Gynecol."},{"key":"2026101508370551200_r7","doi-asserted-by":"crossref","first-page":"1305508","DOI":"10.3389\/fped.2023.1305508","article-title":"Opioid, methamphetamine, and polysubstance use: perinatal outcomes for the mother and infant","volume":"11","author":"Wouldes","year":"2023","journal-title":"Front 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drinking history collected in antenatal clinics","volume":"77","author":"May","year":"2018","journal-title":"Reprod Toxicol."},{"issue":"suppl 2","key":"2026101508370551200_r28","first-page":"39","article-title":"Methodological issues in assessing the impact of prenatal drug exposure","volume":"9","author":"Konijnenberg","year":"2015","journal-title":"Subst Abuse."},{"issue":"4","key":"2026101508370551200_r29","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s42844-020-00021-7","article-title":"Fifty years of research on prenatal substances: lessons learned for the opioid epidemic","volume":"1","author":"Singer","year":"2020","journal-title":"Advers Resil Sci."},{"key":"2026101508370551200_r30","doi-asserted-by":"crossref","first-page":"101432","DOI":"10.1016\/j.dcn.2024.101432","article-title":"Advancing high quality longitudinal data collection: Implications for the HEALthy Brain and Child Development (HBCD) Study design and recruitment","volume":"69","author":"Si","year":"2024","journal-title":"Dev Cogn Neurosci."},{"key":"2026101508370551200_r31","doi-asserted-by":"crossref","first-page":"101421","DOI":"10.1016\/j.dcn.2024.101421","article-title":"The HEALthy Brain and Child Development Study (HBCD) experience: recruiting and retaining diverse families in a longitudinal, multi-method early childhood study","volume":"69","author":"Harden","year":"2024","journal-title":"Dev Cogn Neurosci."},{"key":"2026101508370551200_r32","doi-asserted-by":"crossref","first-page":"101423","DOI":"10.1016\/j.dcn.2024.101423","article-title":"The HEALthy Brain and Child Development Study (HBCD): NIH collaboration to understand the impacts of prenatal and early life experiences on brain development","volume":"69","author":"Volkow","year":"2024","journal-title":"Dev Cogn Neurosci."},{"key":"2026101508370551200_r33","doi-asserted-by":"crossref","first-page":"101447","DOI":"10.1016\/j.dcn.2024.101447","article-title":"The development and structure of the HEALthy Brain and Child Development (HBCD) Study EEG protocol","volume":"69","author":"Fox","year":"2024","journal-title":"Dev Cogn Neurosci."},{"key":"2026101508370551200_r34","doi-asserted-by":"crossref","first-page":"101446","DOI":"10.1016\/j.dcn.2024.101446","article-title":"Remote data collection of infant activity and sleep patterns via wearable sensors in the HEALthy Brain and Child Development Study (HBCD)","volume":"69","author":"Pini","year":"2024","journal-title":"Dev Cogn Neurosci."},{"key":"2026101508370551200_r35","doi-asserted-by":"crossref","first-page":"101420","DOI":"10.1016\/j.dcn.2024.101420","article-title":"Investment, integration, and innovation: fostering diversity, equity, and inclusion across the HEALthy Brain and Child Development (HBCD) Study consortium","volume":"69","author":"Murray","year":"2024","journal-title":"Dev Cogn 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