Prenatal marijuana exposure and neonatal outcomes in Jamaica: an ethnographic study.

OBJECTIVE To identify neurobehavioral effects of prenatal marijuana exposure on neonates in rural Jamaica. DESIGN Ethnographic field studies and standardized neuro-behavior assessments during the neonatal period. SETTING Rural Jamaica in heavy-marijuana-using population. PARTICIPANTS Twenty-four Jamaican neonates exposed to marijuana prenatally and 20 nonexposed neonates. MEASUREMENTS AND MAIN RESULTS Exposed and nonexposed neonates were compared at 3 days and 1 month old, using the Brazelton Neonatal Assessment Scale, including supplementary items to capture possible subtle effects. There were no significant differences between exposed and nonexposed neonates on day 3. At 1 month, the exposed neonates showed better physiological stability and required less examiner facilitation to reach organized states. The neonates of heavy-marijuana-using mothers had better scores on autonomic stability, quality of alertness, irritability, and self-regulation and were judged to be more rewarding for caregivers. CONCLUSIONS The absence of any differences between the exposed on nonexposed groups in the early neonatal period suggest that the better scores of exposed neonates at 1 month are traceable to the cultural positioning and social and economic characteristics of mothers using marijuana that select for the use of marijuana but also promote neonatal development.