Prenatal substance exposure, encompassing alcohol, tobacco, and cannabis, represents a significant and preventable risk factor for childhood psychopathology, contributing to a substantial public health burden (Lee et al., 2024). These exposures can disrupt critical neurodevelopmental processes in utero (Huizink and Mulder, 2006), potentially leading to a range of adverse outcomes, including increased risks of anxiety, attention deficits, and behavioral problems (Huizink and Mulder, 2006, Zammit et al., 2009). Understanding the specific impact of these exposures on child mental health is crucial for informing effective prevention and intervention strategies (Bolhuis et al., 2018, Popova et al., 2018, Muggli et al., 2024, Gerede et al., 2024, Garrison-Desany et al., 2022, Sithisarn et al., 2012).

A growing body of research has linked prenatal exposure to alcohol, tobacco, and cannabis to various neurodevelopmental and psychiatric outcomes (Hill et al., 2000, Lees et al., 2020, Batstra et al., 2003, Winzer-Serhan, 2008, Fried et al., 1992, Goldschmidt et al., 2000, Gray et al., 2005, Cioffredi et al., 2022, Khoury et al., 2018, Navarro et al., 2024). While the specific effects of each substance may vary, they all share the potential to negatively impact neurodevelopment and increase the risk of neuropsychiatry in childhood (ANON, 2018, Sowell et al., 2001, Zhou et al., 2018, Cornelius and Day, 2009, Lambers and Clark, 1996, Volkow et al., 2017, Padilla-Valdez et al., 2025, Legault et al., 2024, Walayat et al., 2024, Hussain et al., 2008, Mukhopadhyay et al., 2010, Le et al., 2024, Robertson et al., 2016). Despite significant advances in developmental psychopathology, the influence of timing and temporal dynamics of prenatal substance exposure on subsequent psychiatric risk is not well understood. The existing literature is sparse and has focused almost exclusively on cannabis. For instance, prenatal cannabis exposure occurring after maternal awareness of pregnancy, compared with exposure before awareness, was associated with greater offspring psychopathology symptoms (Paul et al., 2021, Baranger et al., 2024).

However, critical questions remain unanswered. It is unknown whether the developing brain has distinct vulnerability windows to substance use such as alcohol, tobacco, and cannabis during gestation. Furthermore, it is unclear whether the timing of these exposures predicts specific neuropsychiatric outcomes or transdiagnostic risk dimensions. Addressing these knowledge gaps is essential for developing targeted prevention strategies and refining clinical guidance for substance use during pregnancy.

This study employs a data-driven approach to investigate the associations between prenatal exposure to substances during specific gestational windows and six domains of childhood psychopathology symptoms, using data from the Adolescent Brain Cognitive Development (ABCD) Study. By elucidating these relationships, we seek to identify potential sensitive periods of vulnerability for each substance exposure. Ultimately, this study aims to inform the development of more targeted prevention strategies and public health initiatives, contributing crucial evidence toward minimizing the long-term impact of prenatal substance exposure on child mental health.