Epidemiological association of cannabinoid- and drug- exposures and sociodemographic factors with limb reduction defects across USA 1989–2016: A geotemporospatial study
Introduction: Limb reductions (LR) are rare and dramatic defects which were first described several thousand years ago in the literature of antiquity (Bermejo-Sanchez et al., 2011b, 2011a). More recently they received prominence as the hallmark and initial indication of the teratogenic action of the drug thalidomide (Bermejo-Sanchez et al., 2011b, 2011a). LR includes both absence of proximal limb elements (intercalary segments, phocomelia) as well as complete limb absence (amelia)
Highlights
- Limb reduction rates (LRR) were associated with cannabis use, and THC potency.
- A sharp increase in LRR rates occurred from the fourth to the fifth quintile.
- These relationships were robust to adjustment for ethic and economic covariates.
- They were maintained at geospatiotemporal regression.
- Cannabis legalization was associated with higher LRR's.
Conclusion: Therefore, a spatiotemporal and dose-dependent association between several cannabinoids including THC and cannabigerol and LRR is reported, is robust to adjustment, is consistent with pathophysiological and preclinical studies, accords with findings elsewhere, is markedly exacerbated in higher exposure quintiles, is exacerbated by cannabis legalization and evidences dose-related intergenerational sequaelae.