Epidemiological Patterns of Cannabis- and Substance- Related Congenital Uronephrological Anomalies in Europe Geospatiotemporal and Causal Inferential Study.
Recent reports linking prenatal and community cannabis exposure to elevated uronephrological congenital anomaly (UCA) rates (UCARs) raise the question of its European epidemiology given recent increases in community cannabinoid penetration there. UCAR data from Eurocat. Drug use data from European Monitoring Centre for Drugs and Drug Addiction. Income from World bank. UCAR increased across Spain, Netherlands, Poland and France. UCARs and cannabis resin THC increased simultaneously in France, Spain, Netherlands and Bulgaria. At bivariate analysis all UCAs were related to cannabis herb and resin THC concentrations. All UCARs were bivariately related to cannabis metrics ordered by median minimum E-value (mEV) as hypospadias > multicystic renal disease > bilateral renal agenesis > UCAs > hydronephrosis > posterior urethral valve > bladder exstrophyepispadias. At inverse probability weighted multivariable analysis terms including cannabis were significant for the following series of anomalies UCAs, multicystic renal disease, bilateral renal agenesis, hydronephrosis, congenital posterior urethral valves from P 1.91 × 10 Analysis confirms a close relationship between cannabis metrics and all seven UCAs and fulfill formal criteria for quantitative causal inference. Given the exponential cannabinoid genotoxicity dose-response relationship results provide a powerful stimulus to constrain community cannabinoid exposure including protection of the food chain to preserve the genome and epigenome of coming generations.