Abstract
Up to 20% of pregnant women ages 18–24 consume cannabis during pregnancy. Moreover, clinical studies indicate that cannabis consumption during pregnancy leads to fetal growth restriction (FGR), which is associated with an increased risk of obesity, type II diabetes (T2D), and cardiovascular disease in the offspring. This is of great concern considering that the concentration of Δ9- tetrahydrocannabinol (Δ9-THC), a major psychoactive component of cannabis, has doubled over the last decade and can readily cross the placenta and enter fetal circulation, with the potential to negatively impact fetal development via the endocannabinoid (eCB) system. Cannabis exposure in utero could also lead to FGR via placental insufficiency. In this review, we aim to examine current pre-clinical and clinical findings on the direct effects of exposure to cannabis and its constituents on fetal development as well as indirect effects, namely placental insufficiency, on postnatal metabolic diseases.
Highlights
The worldwide use of cannabis has increased over the past decades [1], and among pregnant women, the usage can be as high as 20% between the ages of 18–24 [2]
There are some mixed results in clinical data, pre-clinical animal studies support the idea that placental abnormalities and fetal growth deficits occur in cannabinoid-exposed offspring (Supplementary Table S1)
Emerging pre-clinical data suggest that ∆9-THC leads to placental insufficiency, early cardiac deficits, dysglycemia and dyslipidemia in adult offspring [81,82,104,131,148] (Figure 3)
Summary
The worldwide use of cannabis has increased over the past decades [1], and among pregnant women, the usage can be as high as 20% between the ages of 18–24 [2]. A recent study has further shown that the majority of mothers understood that the constituents of cannabis are transmitted to the fetus, some still decided to use it, which suggests that there is a misunderstanding regarding its safety in fetal life [8] These misconceptions surrounding maternal cannabis usage warrant a closer look at the potential harms they could exert on the short- and long-term health of the baby. Reports indicate that up to 62% of individuals use CBD to treat pain, anxiety, and depression [26], all common symptoms associated with pregnancy To appreciate how these constituents of cannabis might influence fetal development, it is first imperative to understand the endocannabinoid (eCB) system. Sci. 2021, 22, 9528 of cannabis and its constituents, on the placenta and postnatal metabolic health of the offspring, with an emphasis on ∆9-THC
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