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{{short description|Effects of cannabis consumption during pregnancy}}
'''] consumption in ]''' is associated with restrictions in growth of the fetus, miscarriage, and cognitive deficits in offspring.<ref name=Fonseca2013/>
{{Cannabis sidebar}}
'''Cannabis consumption in pregnancy''' is an important ]. Research has found possible or likely associations between cannabis use and a risk of adverse outcomes in respect of cognitive development, mental health, physical health, and lactation.<ref name=overview/>


Cannabis is the most commonly used controlled substance among pregnant women.<ref name="NCBI">{{cite journal |last1=Wu |first1=CS |last2=Jew |first2=CP |last3=Lu |first3=HC |title=Lasting impacts of prenatal cannabis exposure and the role of endogenous cannabinoids in the developing brain |journal=Future Neurology |date=1 July 2011 |volume=6 |issue=4 |pages=459-480 |pmid=22229018 |pmc=3252200}}</ref>
==Cognitive performance and psychiatric conditions==
Although it is difficult to draw firm conclusions, there is some evidence that prenatal exposure to certain substances, especially marijuana and cocaine, are associated with "deficits in language, attention, areas of cognitive performance, and delinquent behavior in adolescence".<ref>{{cite journal |author=Irner TB |title=Substance exposure in utero and developmental consequences in adolescence: a systematic review |journal=Child Neuropsychol |volume=18 |issue=6 |pages=521–49 |year=2012 |pmid=22114955 |doi=10.1080/09297049.2011.628309 |type=Review}}</ref> Cannabis use during the prenatal developmental phase is a factor in disruption in gene regulation, making offspring potentially vulnerable to addiction and psychiatric conditions, but a "lack of molecular investigations in the human brain as well as the limited knowledge regarding their long-term impact significantly hinders insights about the neurobiology underlying risk for psychiatric disorders".<ref name=Morris >{{cite journal |author=Morris CV, DiNieri JA, Szutorisz H, Hurd YL |title=Molecular mechanisms of maternal cannabis and cigarette use on human neurodevelopment |journal=Eur. J. Neurosci. |volume=34 |issue=10 |pages=1574–83 |year=2011 |month=November |pmid=22103415 |pmc=3226730 |doi=10.1111/j.1460-9568.2011.07884.x|type=Review}}</ref>

A 2011 review of rodent studies by Campolongo ''et al'' found:<ref name= Campolongo2011>{{cite journal |author=Campolongo P, Trezza V, Ratano P, Palmery M, Cuomo V |title=Developmental consequences of perinatal cannabis exposure: behavioral and neuroendocrine effects in adult rodents |journal=Psychopharmacology (Berl.) |volume=214 |issue=1 |pages=5–15 |year=2011 |month=March |pmid=20556598 |pmc=3045519 |doi=10.1007/s00213-010-1892-x|type=Review}}</ref><blockquote>There is increasing evidence from animal studies showing that cannabinoid drugs ... induce enduring neurobehavioral abnormalities in the exposed offspring ... clinical studies report hyperactivity, cognitive impairments and altered emotionality in humans exposed in utero to cannabis. ... Conversely, although animal models allow to control for several confounding factors associated with human studies, they do not take into account environmental and social factors that could influence the long-term neurobehavioral effects of maternal cannabis exposure.<ref name=Campolongo2011/></blockquote>


==Endocannabinoid system== ==Endocannabinoid system==
{{See also|Endocannabinoid system}}
A role in female fertility has long been suspected and studied.<ref name=Sun2012/> Most studies through 2013 linking development of the fetus and cannabis show effects of consumption during the gestational period, but problems in the ] (ECS) during the phase of placental development are also linked with problems in pregnancy.<ref name=Fonseca2013/> According to Sun and Dey (2012), endocanniboid signaling plays a role in "female reproductive events, including preimplantation embryo development, oviductal embryo transport, embryo implantation, placentation, and parturition".<ref name=Sun2012 > {{cite journal |author=Sun X, Dey SK |title=Endocannabinoid signaling in female reproduction |journal=ACS Chem Neurosci |volume=3 |issue=5 |pages=349–55 |year=2012 |month=May |pmid=22860202 |pmc=3382454 |doi=10.1021/cn300014e }}</ref> Karusu ''et al'' (2011) said that a "clear correlation ... in the actual reproductive tissues of miscarrying versus healthy women has yet to be established. However, the adverse effects of marijuana smoke and THC on reproductive functions point to processes that are modulated by ECS."<ref name= Karasu2011>{{cite journal |author=Karasu T, Marczylo TH, Maccarrone M, Konje JC |title=The role of sex steroid hormones, cytokines and the endocannabinoid system in female fertility |journal=Hum. Reprod. Update |volume=17 |issue=3 |pages=347–61 |year=2011 |pmid=21227997 |doi=10.1093/humupd/dmq058 |url=http://humupd.oxfordjournals.org/content/17/3/347.long|type=Review}}</ref> The role of the endocannabinoid system (ECS) in female fertility has long been suspected and studied.<ref name=Sun2012/> Most studies through 2013 linking development of the fetus and cannabis show effects of consumption during the gestational period, but abnormalities in the endocannabinoid system during the phase of placental development are also linked with problems in pregnancy.<ref name=Fonseca2013/> According to Sun and Dey (2012), endocannabinoid signaling plays a role in "female reproductive events, including preimplantation embryo development, oviductal embryo transport, embryo implantation, placentation, and parturition".<ref name=Sun2012 >{{cite journal |vauthors=Sun X, Dey SK |title=Endocannabinoid signaling in female reproduction |journal=ACS Chem Neurosci |volume=3 |issue=5 |pages=349–55 |date=May 2012 |pmid=22860202 |pmc=3382454 |doi=10.1021/cn300014e |type=Review }}</ref> Karusu ''et al'' (2011) said that a "clear correlation ... in the actual reproductive tissues of miscarrying versus healthy women has yet to be established. However, the adverse effects of marijuana smoke and THC on reproductive functions point to processes that are modulated by ECS.".<ref name= Karasu2011>{{cite journal |vauthors=Karasu T, Marczylo TH, Maccarrone M, Konje JC |title=The role of sex steroid hormones, cytokines and the endocannabinoid system in female fertility |journal=Hum. Reprod. Update |volume=17 |issue=3 |pages=347–61 |year=2011 |pmid=21227997 |doi=10.1093/humupd/dmq058 |type=Review|doi-access=free }}</ref>


Keimpema and colleagues (2011) said, "Prenatal cannabis exposure can lead to growth defects during formation of the nervous system"; "annabis impacts the formation and functions of neuronal circuitries by targeting cannabinoid receptors ... By indiscriminately prolonging the "switched-on" period of cannabinoid receptors, cannabis can hijack endocannabinoid signals to evoke molecular rearrangements, leading to the erroneous wiring of neuronal networks".<ref name= Keimpema2011>{{cite journal |author=Keimpema E, Mackie K, Harkany T |title=Molecular model of cannabis sensitivity in developing neuronal circuits |journal=Trends Pharmacol. Sci. |volume=32 |issue=9 |pages=551–61 |year=2011 |month=September |pmid=21757242 |pmc=3159827 |doi=10.1016/j.tips.2011.05.004|type=Review}}</ref> A report prepared for the ] concluded cannabis and other ]s are contraindicated in pregnancy as they may interact with the endocannabinoid system.<ref name="Australia">{{cite book |first1=Jan |last1=Copeland |first2=Saul |last2=Gerber |first3=Wendy |last3=Swift |year=2006 |title=Evidence-based answers to cannabis questions: a review of the literature |location=Canberra |publisher=Australian National Council on Drugs |isbn=978-1-877018-12-1}}</ref><ref name=Fonseca2013>{{cite journal |author=Fonseca BM, Correia-da-Silva G, Almada M, Costa MA, Teixeira NA |title=The Endocannabinoid System in the Postimplantation Period: A Role during Decidualization and Placentation |journal=Int J Endocrinol |volume=2013 |issue= |pages=510540 |year=2013 |pmid=24228028 |pmc=3818851 |doi=10.1155/2013/510540|type=Review }}</ref> Recent data indicates that endometrial expression of cannabinoid receptors in marijuana smoking mothers is higher than non-smokers.<ref name= Neradugomma2018>{{cite journal |vauthors=Neradugomma NK, Drafton K, O'Day DR, Liao MZ, Han LW, Glass IA, Mao Q |title=Marijuana use differentially affects cannabinoid receptor expression in early gestational human endometrium and placenta |journal=Placenta |volume=66 |pages=36–39 |date=9 May 2018 |pmid= 29884300 |pmc=5995327 |doi=10.1016/j.placenta.2018.05.002|type=Research}}</ref> Keimpema and colleagues (2011) said, "Prenatal cannabis exposure can lead to growth defects during formation of the nervous system"; "annabis impacts the formation and functions of neuronal circuitries by targeting cannabinoid receptors ... By indiscriminately prolonging the "switched-on" period of cannabinoid receptors, cannabis can hijack endocannabinoid signals to evoke molecular rearrangements, leading to the erroneous wiring of neuronal networks".<ref name= Keimpema2011>{{cite journal |vauthors=Keimpema E, Mackie K, Harkany T |title=Molecular model of cannabis sensitivity in developing neuronal circuits |journal=Trends Pharmacol. Sci. |volume=32 |issue=9 |pages=551–61 |date=September 2011 |pmid=21757242 |pmc=3159827 |doi=10.1016/j.tips.2011.05.004|type=Review}}</ref> A report prepared for the ] concluded cannabis and other ]s are contraindicated in pregnancy as they may interact with the endocannabinoid system.<ref name=Fonseca2013>{{cite journal |vauthors=Fonseca BM, Correia-da-Silva G, Almada M, Costa MA, Teixeira NA |title=The Endocannabinoid System in the Postimplantation Period: A Role during Decidualization and Placentation |journal=Int J Endocrinol |volume=2013 |pages=510540 |year=2013 |pmid=24228028 |pmc=3818851 |doi=10.1155/2013/510540|type=Review |doi-access=free }}</ref><ref name="Australia">{{cite book |first1=Jan |last1=Copeland |first2=Saul |last2=Gerber |first3=Wendy |last3=Swift |year=2006 |title=Evidence-based answers to cannabis questions: a review of the literature |location=Canberra |publisher=Australian National Council on Drugs |isbn=978-1-877018-12-1}}{{page needed|date=February 2014}}</ref>

==Evidence==

{{asof|2023}} the rising use of cannabis during pregnancy, and the rise in cannabis potency, has become an important ]. Research has found possible or likely associations between cannabis use and a risk of adverse outcomes in respect of cognitive development, mental health, physical health, and lactation.<ref name=overview>{{cite journal |vauthors=Hayer S, Mandelbaum AD, Watch L, Ryan KS, Hedges MA, Manuzak JA, Easley CA, Schust DJ, Lo JO |title=Cannabis and Pregnancy: A Review |journal=Obstet Gynecol Surv |volume=78 |issue=7 |pages=411–428 |date=July 2023 |pmid=37480292 |pmc=10372687 |doi=10.1097/OGX.0000000000001159 |url=}}</ref>

===Mental and cognitive===

Cannabis use during pregnancy is associated with adverse effects on the ] and ] of offspring.<ref name=impact>{{cite journal |vauthors=Lo JO, Hedges JC, Girardi G |title=Impact of cannabinoids on pregnancy, reproductive health, and offspring outcomes |journal=Am J Obstet Gynecol |volume=227 |issue=4 |pages=571–581 |date=October 2022 |pmid=35662548 |pmc=9530020 |doi=10.1016/j.ajog.2022.05.056 |type=Review}}</ref> The THC exposure resulting from cannabis use interferes with fetal brain development and the male offspring of users are more susceptible to psychotic illness.<ref name=frau>{{cite journal |vauthors=Frau R, Melis M |title=Sex-specific susceptibility to psychotic-like states provoked by prenatal THC exposure: Reversal by pregnenolone |journal=J Neuroendocrinol |volume=35 |issue=2 |pages=e13240 |date=February 2023 |pmid=36810840 |doi=10.1111/jne.13240 |type=Review|hdl=11584/360819 |hdl-access=free }}</ref>

=== Epigenetics ===

THC exposure in rats during the prenatal developmental phase may cause ] changes in gene expression, but there is limited knowledge about the risk for psychiatric disorders because of ethical barriers to studying the developing human brain.<ref name=Morris >{{cite journal |vauthors=Morris CV, DiNieri JA, Szutorisz H, Hurd YL |title=Molecular mechanisms of maternal cannabis and cigarette use on human neurodevelopment |journal=Eur. J. Neurosci. |volume=34 |issue=10 |pages=1574–83 |date=November 2011 |pmid=22103415 |pmc=3226730 |doi=10.1111/j.1460-9568.2011.07884.x|type=Review}}</ref> A 2015 review found that cannabis use by pregnant mothers corresponded to impaired brain maturation in their children, and that those children were more predisposed to ]s; these results do not demonstrate causality.<ref>{{cite journal|last1=Alpár|first1=A|last2=Di Marzo|first2=V|last3=Harkany|first3=T|title=At the Tip of an Iceberg: Prenatal Marijuana and Its Possible Relation to Neuropsychiatric Outcome in the Offspring|journal=Biological Psychiatry|date=25 September 2015|doi=10.1016/j.biopsych.2015.09.009|pmid=26549491|volume=79|issue=7|pages=e33–e45|s2cid=18847084}}</ref>

=== Confounding factors ===

The ] stated in 2018 that further research is required to "disentangle" effects of cannabis use from a mother's concomitant drug use and other environmental factors.<ref name="NIDAconfounding">{{cite web |url=https://www.drugabuse.gov/publications/research-reports/marijuana/can-marijuana-use-during-pregnancy-harm-baby |website=National Institute on Drug Abuse |access-date=28 October 2018 |title=Can marijuana use during and after pregnancy harm the baby?}}</ref>

== Developmental observations ==

Developmental observations suggest that CB1 receptors develop only gradually during the ], which block for the ] effects of cannabinoid treatment in the young organism. Therefore, it is suggested that children may respond positively to medicinal applications of cannabinoids without undesirable central effects. Clinical results have been reported in ] and in case studies of children with severe ] or ], and ] (CF) suggesting cannabinoid treatment for ] or ], in order to achieve an improvement of their health condition including improved food intake and reduced ] exacerbations.<ref>{{Cite journal|last=Fride|first=Ester|date=2004|title=The endocannabinoid-CB receptor system: Importance for development and in pediatric disease|url=https://pubmed.ncbi.nlm.nih.gov/15159678/|journal=Neuro Endocrinology Letters|volume=25|issue=1–2|pages=24–30|issn=0172-780X|pmid=15159678}}</ref>

== Morning sickness/hyperemesis gravidarum ==
] (HG), is a debilitating ailment characterized by severe ] and ], ], and ] during pregnancy, and occurs to 1-2% of pregnant women ]. It is a perplexing female mystery for the present-day medical establishment. The frustration is mostly felt by women who are survivors of HG, desperately searching for a cure and increased understanding of this disease. Several pregnant women have revealed their personal experience with cannabis, having used it to relieve symptoms of HG, who would otherwise have become severely ], ], and malnourished due to persistent, uncontrollable vomiting and the inability to eat and ] in their pregnancy.<ref name=":0">{{Cite web|last=Curry|first=Wei-Ni Lin|date=2002|title=Hyperemesis Gravidarum and Clinical Cannabis: To Eat or Not to Eat?|url=http://www.cannabis-med.org/membersonly/mo.php?aid=2002-03-04&fid=2002-03-04-4&mode=p&sid=|website=cannabis-med.org}}</ref><ref>{{Cite journal|last1=Westfall|first1=Rachel E.|last2=Janssen|first2=Patricia A.|last3=Lucas|first3=Philippe|last4=Capler|first4=Rielle|date=2006-02-01|title=Survey of medicinal cannabis use among childbearing women: Patterns of its use in pregnancy and retroactive self-assessment of its efficacy against 'morning sickness'|url=https://www.sciencedirect.com/science/article/pii/S1744388105000939|journal=Complementary Therapies in Clinical Practice|language=en|volume=12|issue=1|pages=27–33|doi=10.1016/j.ctcp.2005.09.006|pmid=16401527|issn=1744-3881}}</ref>

== Society and culture ==
It is a common misconception that cannabis use in pregnancy is low risk; a 2015 study found that 70% of women in the ] assume that using cannabis 1-2 times a week while pregnant is safe.<ref name="pmid25772211">{{cite journal| author=Ko JY, Farr SL, Tong VT, Creanga AA, Callaghan WM| title=Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age. | journal=Am J Obstet Gynecol | year= 2015 | volume= 213 | issue= 2 | pages= 201.e1-201.e10 | pmid=25772211 | doi=10.1016/j.ajog.2015.03.021 | pmc=7469257 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25772211 }} </ref>


==See also== ==See also==
*] *]
*]


==References== ==References==
{{reflist}} {{reflist}}

==Further reading ==
* {{cite journal |author=Hoell I, Havemann-Reinecke U |title= |language=German |journal=Med Monatsschr Pharm |volume=34 |issue=10 |pages=363–74; quiz 375–6 |year=2011 |month=October |pmid=22010420}}
* {{cite journal |author=Huizink AC |title=Prenatal substance use, prenatal stress and offspring behavioural outcomes: considerations for future studies |journal=Nord J Psychiatry |volume=66 |issue=2 |pages=115–22 |year=2012 |month=April |pmid=22242892 |doi=10.3109/08039488.2011.641586}}
* {{cite journal |author=Jutras-Aswad D, DiNieri JA, Harkany T, Hurd YL |title=Neurobiological consequences of maternal cannabis on human fetal development and its neuropsychiatric outcome |journal=Eur Arch Psychiatry Clin Neurosci |volume=259 |issue=7 |pages=395–412 |year=2009 |month=October |pmid=19568685 |doi=10.1007/s00406-009-0027-z}}


{{Cannabis}} {{Cannabis}}
{{Pregnancy}}

] ]
] ]
]

Latest revision as of 08:44, 19 December 2024

Effects of cannabis consumption during pregnancy
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Cannabis consumption in pregnancy is an important public health issue. Research has found possible or likely associations between cannabis use and a risk of adverse outcomes in respect of cognitive development, mental health, physical health, and lactation.

Cannabis is the most commonly used controlled substance among pregnant women.

Endocannabinoid system

See also: Endocannabinoid system

The role of the endocannabinoid system (ECS) in female fertility has long been suspected and studied. Most studies through 2013 linking development of the fetus and cannabis show effects of consumption during the gestational period, but abnormalities in the endocannabinoid system during the phase of placental development are also linked with problems in pregnancy. According to Sun and Dey (2012), endocannabinoid signaling plays a role in "female reproductive events, including preimplantation embryo development, oviductal embryo transport, embryo implantation, placentation, and parturition". Karusu et al (2011) said that a "clear correlation ... in the actual reproductive tissues of miscarrying versus healthy women has yet to be established. However, the adverse effects of marijuana smoke and THC on reproductive functions point to processes that are modulated by ECS.".

Recent data indicates that endometrial expression of cannabinoid receptors in marijuana smoking mothers is higher than non-smokers. Keimpema and colleagues (2011) said, "Prenatal cannabis exposure can lead to growth defects during formation of the nervous system"; "annabis impacts the formation and functions of neuronal circuitries by targeting cannabinoid receptors ... By indiscriminately prolonging the "switched-on" period of cannabinoid receptors, cannabis can hijack endocannabinoid signals to evoke molecular rearrangements, leading to the erroneous wiring of neuronal networks". A report prepared for the Australian National Council on Drugs concluded cannabis and other cannabinoids are contraindicated in pregnancy as they may interact with the endocannabinoid system.

Evidence

As of 2023 the rising use of cannabis during pregnancy, and the rise in cannabis potency, has become an important public health issue. Research has found possible or likely associations between cannabis use and a risk of adverse outcomes in respect of cognitive development, mental health, physical health, and lactation.

Mental and cognitive

Cannabis use during pregnancy is associated with adverse effects on the mental health and cognitive performance of offspring. The THC exposure resulting from cannabis use interferes with fetal brain development and the male offspring of users are more susceptible to psychotic illness.

Epigenetics

THC exposure in rats during the prenatal developmental phase may cause epigenetic changes in gene expression, but there is limited knowledge about the risk for psychiatric disorders because of ethical barriers to studying the developing human brain. A 2015 review found that cannabis use by pregnant mothers corresponded to impaired brain maturation in their children, and that those children were more predisposed to neurodevelopmental disorders; these results do not demonstrate causality.

Confounding factors

The National Institute on Drug Abuse stated in 2018 that further research is required to "disentangle" effects of cannabis use from a mother's concomitant drug use and other environmental factors.

Developmental observations

Developmental observations suggest that CB1 receptors develop only gradually during the postnatal period, which block for the psychoactive effects of cannabinoid treatment in the young organism. Therefore, it is suggested that children may respond positively to medicinal applications of cannabinoids without undesirable central effects. Clinical results have been reported in pediatric oncology and in case studies of children with severe neurological disease or brain trauma, and cystic fibrosis (CF) suggesting cannabinoid treatment for children or young adults, in order to achieve an improvement of their health condition including improved food intake and reduced inflammatory exacerbations.

Morning sickness/hyperemesis gravidarum

Hyperemesis Gravidarum (HG), is a debilitating ailment characterized by severe nausea and vomiting, malnutrition, and weight loss during pregnancy, and occurs to 1-2% of pregnant women globally. It is a perplexing female mystery for the present-day medical establishment. The frustration is mostly felt by women who are survivors of HG, desperately searching for a cure and increased understanding of this disease. Several pregnant women have revealed their personal experience with cannabis, having used it to relieve symptoms of HG, who would otherwise have become severely emaciated, dehydrated, and malnourished due to persistent, uncontrollable vomiting and the inability to eat and drink in their pregnancy.

Society and culture

It is a common misconception that cannabis use in pregnancy is low risk; a 2015 study found that 70% of women in the United States assume that using cannabis 1-2 times a week while pregnant is safe.

See also

References

  1. ^ Hayer S, Mandelbaum AD, Watch L, Ryan KS, Hedges MA, Manuzak JA, Easley CA, Schust DJ, Lo JO (July 2023). "Cannabis and Pregnancy: A Review". Obstet Gynecol Surv. 78 (7): 411–428. doi:10.1097/OGX.0000000000001159. PMC 10372687. PMID 37480292.
  2. Wu, CS; Jew, CP; Lu, HC (1 July 2011). "Lasting impacts of prenatal cannabis exposure and the role of endogenous cannabinoids in the developing brain". Future Neurology. 6 (4): 459–480. PMC 3252200. PMID 22229018.
  3. ^ Sun X, Dey SK (May 2012). "Endocannabinoid signaling in female reproduction". ACS Chem Neurosci (Review). 3 (5): 349–55. doi:10.1021/cn300014e. PMC 3382454. PMID 22860202.
  4. ^ Fonseca BM, Correia-da-Silva G, Almada M, Costa MA, Teixeira NA (2013). "The Endocannabinoid System in the Postimplantation Period: A Role during Decidualization and Placentation". Int J Endocrinol (Review). 2013: 510540. doi:10.1155/2013/510540. PMC 3818851. PMID 24228028.
  5. Karasu T, Marczylo TH, Maccarrone M, Konje JC (2011). "The role of sex steroid hormones, cytokines and the endocannabinoid system in female fertility". Hum. Reprod. Update (Review). 17 (3): 347–61. doi:10.1093/humupd/dmq058. PMID 21227997.
  6. Neradugomma NK, Drafton K, O'Day DR, Liao MZ, Han LW, Glass IA, Mao Q (9 May 2018). "Marijuana use differentially affects cannabinoid receptor expression in early gestational human endometrium and placenta". Placenta (Research). 66: 36–39. doi:10.1016/j.placenta.2018.05.002. PMC 5995327. PMID 29884300.
  7. Keimpema E, Mackie K, Harkany T (September 2011). "Molecular model of cannabis sensitivity in developing neuronal circuits". Trends Pharmacol. Sci. (Review). 32 (9): 551–61. doi:10.1016/j.tips.2011.05.004. PMC 3159827. PMID 21757242.
  8. Copeland, Jan; Gerber, Saul; Swift, Wendy (2006). Evidence-based answers to cannabis questions: a review of the literature. Canberra: Australian National Council on Drugs. ISBN 978-1-877018-12-1.
  9. Lo JO, Hedges JC, Girardi G (October 2022). "Impact of cannabinoids on pregnancy, reproductive health, and offspring outcomes". Am J Obstet Gynecol (Review). 227 (4): 571–581. doi:10.1016/j.ajog.2022.05.056. PMC 9530020. PMID 35662548.
  10. Frau R, Melis M (February 2023). "Sex-specific susceptibility to psychotic-like states provoked by prenatal THC exposure: Reversal by pregnenolone". J Neuroendocrinol (Review). 35 (2): e13240. doi:10.1111/jne.13240. hdl:11584/360819. PMID 36810840.
  11. Morris CV, DiNieri JA, Szutorisz H, Hurd YL (November 2011). "Molecular mechanisms of maternal cannabis and cigarette use on human neurodevelopment". Eur. J. Neurosci. (Review). 34 (10): 1574–83. doi:10.1111/j.1460-9568.2011.07884.x. PMC 3226730. PMID 22103415.
  12. Alpár, A; Di Marzo, V; Harkany, T (25 September 2015). "At the Tip of an Iceberg: Prenatal Marijuana and Its Possible Relation to Neuropsychiatric Outcome in the Offspring". Biological Psychiatry. 79 (7): e33–e45. doi:10.1016/j.biopsych.2015.09.009. PMID 26549491. S2CID 18847084.
  13. "Can marijuana use during and after pregnancy harm the baby?". National Institute on Drug Abuse. Retrieved 28 October 2018.
  14. Fride, Ester (2004). "The endocannabinoid-CB receptor system: Importance for development and in pediatric disease". Neuro Endocrinology Letters. 25 (1–2): 24–30. ISSN 0172-780X. PMID 15159678.
  15. Curry, Wei-Ni Lin (2002). "Hyperemesis Gravidarum and Clinical Cannabis: To Eat or Not to Eat?". cannabis-med.org.
  16. Westfall, Rachel E.; Janssen, Patricia A.; Lucas, Philippe; Capler, Rielle (2006-02-01). "Survey of medicinal cannabis use among childbearing women: Patterns of its use in pregnancy and retroactive self-assessment of its efficacy against 'morning sickness'". Complementary Therapies in Clinical Practice. 12 (1): 27–33. doi:10.1016/j.ctcp.2005.09.006. ISSN 1744-3881. PMID 16401527.
  17. Ko JY, Farr SL, Tong VT, Creanga AA, Callaghan WM (2015). "Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age". Am J Obstet Gynecol. 213 (2): 201.e1-201.e10. doi:10.1016/j.ajog.2015.03.021. PMC 7469257. PMID 25772211.{{cite journal}}: CS1 maint: multiple names: authors list (link)
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