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%; < 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; < 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..
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