A systematic review of 33 studies found prenatal cannabis exposure is linked to age-dependent self-regulation problems in young children, with regulatory difficulties becoming more apparent after age 2.
Developmental pediatricians, early childhood educators, prenatal care providers, parents.
33 studies: regulation problems emerge after age 2
What the researchers found
From 1,061 screened articles, 33 were included. Diminished regulatory abilities were more common in infants after prenatal cannabis exposure, while specific regulatory problems (behavioral, emotional) were more frequently found after age 2. Mechanisms included changes in methylation and expression of endocannabinoid, dopaminergic, and opioid system genes, increased cortisol reactivity, altered immune markers, and changes in brain structure and connectivity.
Why it matters
Self-regulation, the ability to control attention, emotions, and behavior, is foundational for child development. This review shows that prenatal cannabis exposure may undermine these abilities through multiple neurobiological pathways, with effects that become more apparent as children reach ages where self-regulation demands increase.
The numbers in context
33 studies included from 1,061 screened. Children ages 0-6. Regulatory difficulties more apparent after age 2. Multiple mechanisms identified: gene methylation, cortisol, brain structure changes.
How the study worked
Systematic review following PRISMA guidelines, searching Medline, Web of Science, and PsycInfo. Included studies of children ages 0-6 with preconception, prenatal, or postnatal cannabis exposure. Investigated regulatory abilities, regulatory problems, and neurobiological mechanisms. Registered with PROSPERO.
What this study cannot tell us
Limited number of studies meeting criteria. Small sample sizes in many studies. Lack of control for maternal psychopathology in most studies. Cannabis exposure poorly quantified in many studies. Cannot fully separate cannabis effects from co-occurring risk factors.
How to read the evidence
Moderate: registered systematic review with clear methodology, though limited by small number of qualifying studies and poor exposure quantification.
When this study was published
2025 study
The bigger picture
The age-dependent pattern, with problems emerging more clearly after age 2, has important implications for early screening. Children exposed prenatally may appear normal in infancy but develop behavioral and emotional regulation difficulties as developmental demands increase, creating a false sense of reassurance during the first years of life.
Questions still open
- Do regulatory problems continue to worsen as children age beyond 6? Can early intervention mitigate regulation difficulties in exposed children? Which specific neurobiological mechanisms are most amenable to intervention?
Common questions
Does prenatal cannabis affect children's behavior?
Why do problems appear later rather than at birth?
Read the original research
Systematic review: the impact of maternal pre-and postnatal cannabis use on the behavioral and emotional regulation in early childhood.
European child & adolescent psychiatry, 34(2), 423-463
Citation
Reyentanz, Emely; Gerlach, Jennifer; Kuitunen-Paul, Sören; Golub, Yulia. (2025). Systematic review: the impact of maternal pre-and postnatal cannabis use on the behavioral and emotional regulation in early childhood.. European child & adolescent psychiatry, 34(2), 423-463. https://doi.org/10.1007/s00787-024-02494-8
Explore the wider topic
- How to Talk to Your Teenager About Weed (Without Losing Them)
- My Kid's Friends Smoke Weed: A Parent's Guide
- I Smoke Weed But Don't Want My Kids To: Navigating the Hypocrisy
- Quitting Weed as a Parent: Why It Is the Hardest and Most Important Quit
- Quitting Weed as a Teen or Young Adult
- My Kid Is Smoking Weed: A Parent's Guide