A systematic review found prenatal cannabis exposure may be associated with affective symptoms and ADHD in offspring, but the evidence base is limited and the topic under-researched.
Obstetricians, developmental pediatricians, and pregnant women considering cannabis use.
Prenatal cannabis linked to ADHD and mood symptoms; at least 5% of pregnancies exposed
What the researchers found
Cannabis use among pregnant women is common (~5% or more), with risk factors including younger age, lower education, and concurrent tobacco/alcohol use. Prenatal cannabis exposure may be associated with affective symptoms and ADHD in children. However, the review found the topic has not been extensively researched despite increasing cannabis use during pregnancy, creating a gap between public behavior and scientific knowledge.
Why it matters
Cannabis is increasingly seen as "natural" and safe during pregnancy, yet the evidence on developmental consequences is sparse. This review highlights the disconnect between growing prenatal cannabis use and the limited evidence to guide pregnant women.
The numbers in context
At least 5% of pregnant women use cannabis; associated with affective symptoms and ADHD in offspring; risk factors: younger age, lower education, concurrent substance use.
How the study worked
Systematic review of PubMed through July 2018 for studies on maternal cannabis use and the relationship between prenatal exposure and developmental and psychiatric disorders, in English and Spanish.
What this study cannot tell us
Limited number of studies meeting criteria; heterogeneous study designs; difficulty isolating cannabis effects from concurrent tobacco, alcohol, and other drug use; self-report of cannabis use during pregnancy likely underestimates true prevalence.
How to read the evidence
Moderate: systematic methodology but limited by sparse and heterogeneous primary studies.
When this study was published
Published 2020.
The bigger picture
As cannabis is legalized and destigmatized, prenatal use is likely increasing. The limited evidence base means clinical guidance is based largely on precaution. Robust prospective studies tracking neurodevelopment from prenatal exposure through childhood are urgently needed.
Questions still open
- Are specific trimesters more vulnerable to cannabis exposure? Does the cannabinoid type (THC vs CBD) matter for fetal neurodevelopment?
Common questions
Is cannabis safe during pregnancy?
How common is cannabis use during pregnancy?
Read the original research
Cannabis use during pregnancy and its relationship with fetal developmental outcomes and psychiatric disorders. A systematic review.
Reproductive health, 17(1), 25
Citation
Roncero, Carlos; Valriberas-Herrero, Isabel; Mezzatesta-Gava, Marcela; Villegas, José L; Aguilar, Lourdes; Grau-López, Lara. (2020). Cannabis use during pregnancy and its relationship with fetal developmental outcomes and psychiatric disorders. A systematic review.. Reproductive health, 17(1), 25. https://doi.org/10.1186/s12978-020-0880-9
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