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MotherToBaby

Medications and More during pregnancy and breastfeeding

Marijuana (Cannabis)

Selected References

  • American College of Obstetricians and Gynecologists (ACOG). 2017 (Reaffirmed 2021). Marijuana Use During Pregnancy and Lactation. ACOG Committee Opinion Number. 722. Obstetrics & Gynecology 130(4).
  • Arora M, et al. 2025. Cannabis use & female infertility: A cross sectional analysis of the National Health and Nutrition Examination Survey, 2013-2018. Ann Epidemiol. 104:1-7.
  • Astley SJ, Little RE. 1990. Maternal marijuana use during lactation and infant development at one year. Neurotoxicol Teratol 12:161–8.
  • Avalos LA, et al. 2024. Early maternal prenatal cannabis use and child developmental delays. JAMA Netw Open. 7(10):e2440295.
  • Avalos LA, et al. 2024. Neonatal outcomes associated with in utero cannabis exposure: a population-based retrospective cohort study. Am J Obstet Gynecol. 231(1):132.e1-132.e13.
  • Bandoli G, et al. Cannabis-related diagnosis in pregnancy and adverse maternal and infant outcomes. Drug Alcohol Depend 225:108757.
  • Bertrand KA, et al. 2018. Marijuana use by breastfeeding mothers and cannabinoid concentrations in breast milk. Pediatrics 142:e20181076.
  • Brik M, et al. 2024. Cannabis exposure during pregnancy and perinatal outcomes: a cohort study. Acta Obstet Gynecol Scand. 103(6):1083-1091.
  • Carroll K, et al. 2020. Marijuana use and its influence on sperm morphology and motility: identified risk for fertility among Jamaican men. Andrology 8(1):136-142.
  • Chabarria KC, et al. 2016. Marijuana use and its effects in pregnancy. Am J Obstet Gynecol 215(4):506.e1-7.
  • Cioffredi LA, et al. 2022. Prenatal cannabis exposure predicts attention problems, without changes on fMRI in adolescents. Neurotoxicology and teratology 91, 107089.
  • Coleman-Cowger V, et al. 2018. Prevalence and associated birth outcomes of co-use of cannabis and tobacco cigarettes during pregnancy. Neurotoxicity and Teratology 68:84-90
  • Committee on Drugs, American Academy of Pediatrics. 2001. The transfer of drugs and other chemicals into human breast milk. Pediatrics 108:776-89.
  • Corsi DJ, et. al. 2020. Maternal cannabis use in pregnancy and child neurodevelopmental outcomes. Nat Med; 26, 1536-1540.
  • Davis, E, et al. 2020. Cannabis use in pregnancy and breastfeeding: The pharmacist’s role. Can Pharm J 153(2):95-100.
  • Delker E, et al. 2022. Prenatal exposure to cannabis and risk of major structural birth defects: A systematic review and meta-analysis. Ob Gyn 142(2):269-283
  • Delker E, et al. 2024. Prenatal cannabis use disorder and gastroschisis in California, 2007-19. Int J Epidemiol. 53(2):dyae042.
  • ElSohly MA, et al. 2016. Changes in cannabis potency over the last 2 decades (1995-2014): Analysis of current data in the united states. biol psychiatry. 79(7):613-9.
  • Feinshtein V, et al. 2013. Cannabidiol changes P-gp and BCRP expression in trophoblast cell lines. PeerJ 1:e153.
  • Fried PA, Smith AM. 2001. A lit review of the consequences of prenatal marihuana exposure. An emerging theme of a deficiency in aspects of executive function. Neurotoxicol Teratol 23:1-11.
  • Fronczak CM, et al. 2012. The insults of illicit drug use on male fertility. J Androl 33(4): 515-528.
  • Goldschmidt L, et al. 2004. Prenatal marijuana and alcohol exposure and academic achievement at age 10. Neurotoxicol Teratol 26(4):521-32.
  • Goldschmidt L, et al. 2008. Prenatal marijuana and intelligence test performance at age 6. J Am Acad Child Adolesc Psychiatry 47(3):254-263.
  • Goldschmidt L, et al. 2016. Early marijuana initiation: Link between prenatal marijuana exposure, early childhood behavior, and negative adult roles. Neurotoxicol Teratol 58:40-45.
  • Gray T, et al. 2010. Identifying prenatal cannabis exposure and effects of concurrent tobacco exposure on neonatal growth. Clin Chem 56(9):1442-1450.
  • Gundersen TD, et al. 2015. Association between use of marijuana and male reproductive hormones and semen quality: A study among 1,215 healthy young men. Am J Epidemiol.;182(6):473-481.
  • Hale D, Phillips W. 2022. Cannabis withdrawal in two newborns. Abstract published at SHM Converge 2022. Abstract G24 Journal of Hospital Medicine. https://shmabstracts.org/abstract/cannabis-withdrawal-in-two-newborns/.
  • Harhangi MS, et al. 2025. Placental endocannabinoid system: focus on preeclampsia and cannabis use. Hypertension. 82(5):804-815.
  • Harris M, et al. 2023. Academy of Breastfeeding Medicine Clinical Protocol #21: Breastfeeding in the Setting of Substance Use and Substance Use Disorder (Revised 2023). Breastfeed Med. 18(10):715-733.
  • Hayatbakhsh MR, et al. 2012. Birth outcomes associated with cannabis use before and during pregnancy. Pediatric Res 71(2): 215-219.
  • Hehemann MC, et al. 2021. Evaluation of the impact of marijuana use on semen quality: a prospective analysis. Therapeutic Advances in Urology 13:17562872211032484.
  • Huizink A. 2009. Moderate use of alcohol, tobacco, and cannabis during pregnancy: New approaches and update on research findings. Reprod Toxicol 28:143-151.
  • Jones MJ, et al. 2022. Prenatal marijuana exposure and neonatal outcomes: a retrospective cohort study. BMJ open, 12(9), e061167.
  • Karatayev O, et al. 2024. Neurological disorders induced by drug use: effects of adolescent and embryonic drug exposure on behavioral neurodevelopment. Int J Mol Sci. 25(15):8341.
  • Keim SA, et al. 2024. Prenatal cannabis exposure and executive function and aggressive behavior at age 5 years. JAMA Pediatr. 178(12):1316-1325.
  • Lam PK and Torfs CP. 2006. Interaction between maternal smoking and malnutrition in infant risk of gastroschisis. Birth Defects Res 76:182-186.
  • Leech SL, et al. 1999. Prenatal substance exposure: effects on attention and impulsivity of 6-year-olds. Neurotoxicol Teratol 21(2):109-18.
  • Leemaqz SY, et al, SCOPE Consortium. 2016. Maternal marijuana use has independent effects on risk for spontaneous preterm birth but not other common later pregnancy complications. Reprod Toxicol 62:77-86.
  • Liston J. 1998. Breastfeeding and the use of recreational drugs alcohol, caffeine, nicotine and marijuana. Breastfeed Rev 6(2):27-30.
  • Matrin GI. 2020. Marijuana: The effects on pregnancy, the fetus, and the newborn. J Perinatology; 40, 1470-1476.
  • Metz TD, et al. 2017. Maternal marijuana use, adverse pregnancy outcomes, and neonatal morbidity. Am J Obstet Gynecol; 217:478.e1-8.
  • Moore BF, et al. 2025. Impact of prenatal exposure to delta 9-tetrahydrocannabinol and cannabidiol on birth size and postnatal growth trajectories. Pediatr Obes. 20(1):e13187.
  • Moss MJ, et al. 2021. Cannabis use and measurement of cannabinoids in plasma and breast milk of breastfeeding mothers. Pediatric research, 90(4), 861–868.
  • Narayanan P, et al. 2025. The effect of cannabis consumption during lactation on the macronutrient concentrations in breast milk. Breastfeeding Medicine. 20(1):33–41.
  • Neradugomma NK, et al. 2019. Marijuana-derived cannabinoids inhibit uterine endometrial stromal cell decidualization and compromise trophoblast-endometrium cross-talk. Reprod Toxicol; 87:100-107.
  • Nguyen VH, Harley KG. 2022. Prenatal cannabis use and infant birth outcomes in the Pregnancy Risk Assessment Monitoring System. The Journal of pediatrics, 240, 87–93.
  • Petersen JM, et al. 2025. An exploration of potential risk factors for gastroschisis using decision tree learning. Ann Epidemiol. 101:19-26.
  • Pleau J, et al. 2025. Longitudinal associations between cannabis use during pregnancy and child cognitive, motor, and language development at 2 years old. Matern Child Health J 29(4):549-562.
  • Roca A, et al. 2021. Clinical features and risk factors associated with prenatal exposure to drugs of abuse. Anales de pediatria, 95(5), 307–320.
  • Ryan SA, et al. 2018. . Marijuana use during pregnancy and breastfeeding: implications for neonatal and childhood outcomes, Pediatrics. 142(3):e20181889.
  • Sarrafpour S, et. al. 2020. Considerations and Implications of cannabidiol use during pregnancy. Curr Pain Headache Rep; 24, 38.
  • Sasso EB, et al. 2021. Marijuana use and perinatal outcomes in obstetric patients at a safety net hospital. European journal of obstetrics, gynecology, and reproductive biology, 266, 36–41.
  • Smith AM, et al. 2004. Effects of prenatal marijuana on response inhibition: an MRI study of young adults Neurotoxicol Teratol 26(4):533-42.
  • Sonon, KE, et al. 2014. Prenatal marijuana exposure predicts marijuana use in young adulthood. Neurotoxicol Teratol. 47:10–15.
  • Tadesse AW, et al. 2025. Maternal cannabis use disorder and neonatal health outcomes: a data linkage study. BJOG. 132(4):529-538.
  • Tadesse AW, et al. 2025. Maternal cannabis use disorder and offspring behavioral outcomes: findings from a linked data cohort study. Psychiatry Res. 346:116404.
  • Thompson R, et al. 2019. Marijuana use in pregnancy: A review. Obstet Gynecol Surv. 74(7):415-428.
  • S. Food and Drug Administration (FDA). 2019. What You Should Know About Using Cannabis, Including CBD, When Pregnant or Breastfeeding: Available at: https://www.fda.gov/consumers/consumer-updates/what-you-should-know-about-using-cannabis-including-cbd-when-pregnant-or-breastfeeding [Accessed 10/2022].
  • Varner MW, et al. 2014. Association between stillbirth and illicit drug use and smoking during pregnancy. Obstet Gynecol; 123(1):113-25.
  • Weinsheimer RL, et al. 2008. Impact of maternal substance abuse and smoking on children with gastroschisis. J Pediatr Surg 43:879-883.
  • Williams LJ, et al. 2004. Maternal lifestyle factors and risk for ventricular septal defects. Birth Defects Res A Clin Mol Teratol 70:59-64.
  • Young-Wolff KC, et al. 2024. Prenatal cannabis use and maternal pregnancy outcomes. JAMA Intern Med. 184(9):1083–1093.
  • Young-Wolff KC, et al. 2025. Prenatal cannabis use and offspring attention deficit hyperactivity disorder and disruptive behavior disorders: a retrospective cohort study. J Dev Behav Pediatr. 46(1):e25-e32.

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