Associations of first trimester co-use of tobacco and Cannabis with prenatal immune response and psychosocial well-being

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9 Scopus citations


Purpose: This study aims to describe the association of first trimester co-use of tobacco and cannabis with maternal immune response and psychosocial well-being, relative to tobacco use only. Methods: A preliminary midpoint analysis included 138 pregnant women with biologically verified tobacco use, 38 of whom (28%) also tested positive for recent cannabis use. Maternal perceived stress (Perceived Stress Scale), depressive symptoms (Edinburgh Postnatal Depression Scale), and serum immune markers (IL-1β IL-2, IL-6, IL-8, IL-10, TNFα CRP, MMP8), were collected, although cytokine data were only available for 122 women. Results: Participant average age was 29.1 years, approximately half had a high school education or less, and half were unemployed. Compared to tobacco only users, co-users were more likely to be non-White, younger and more economically disadvantaged. In the adjusted linear regression models, TNF-α levels were significantly lower among co-users relative to tobacco only users, after adjusting for age, race/ethnicity, body mass index and tobacco use group (tobacco cigarettes, electronic nicotine delivery devices [ENDS] or both). TNF-α was the only immune marker found to be significant in this analysis. Measured stress levels (M = 5.9, SD = 3.3; potential range 0–16) and depression scores (M = 7.8, SD = 5.8; potential range 0–30) were low across all participants and did not differ as a function of co-use. Conclusion: Preliminary results suggest women co-using during the first trimester exhibit decreased pro-inflammatory immune responsivity on one out of eight markers. Further research is needed to determine the impact of this immune modulation on fetal health outcomes and the unique contribution of cannabis.

Original languageEnglish
Pages (from-to)42-48
Number of pages7
JournalNeurotoxicology and Teratology
StatePublished - May 1 2019

Bibliographical note

Funding Information:
This work was conducted at the University of Kentucky in Lexington, Kentucky, and supported in part by National Institute on Drug Abuse grant number R01DA040694-01 (PI: K Ashford). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Additional support was provided through the University of Kentucky Center for Clinical and Translational Science (NIH grant UL1TROO1998 ) REDCap research project database.

Publisher Copyright:
© 2019


  • Cytokines
  • Marijuana
  • Nicotine
  • Perceived stress
  • Pregnancy

ASJC Scopus subject areas

  • Toxicology
  • Developmental Neuroscience
  • Cellular and Molecular Neuroscience


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