The changing landscape of cannabis use: impact on maternal health and neonatal outcomes.

The landscape of cannabis use has changed rapidly, with over 40% of adults aged 19 to 30 years using cannabis in the past year. Of great concern is the rising prevalence in pregnant women, fueled by the legalization and its public perception of safety. However, emerging evidence from animal/in vitro and human studies suggests that prenatal cannabis exposure influence maternal physiology and fetal development, with impact on short- and long-term outcomes. While cannabis exposure is well-known for its impacts on cognitive functioning and neurodevelopment, it also affects other organ systems, leading to long-term cardiovascular, hematologic, gastrointestinal, growth, and endocrine/metabolic dysregulations. This narrative mini-review describes the historical background of cannabis, and provides an overview of how prenatal cannabis exposure affect maternal physiology and fetal development across multiple organ systems. We aim to provide clinicians with a practical understanding of the biological and developmental impact of prenatal cannabis exposure to support evidence-informed counseling during pregnancy and lactation. IMPACT: Prenatal cannabis exposure disrupts maternal metabolic regulation, placental function, and fetal development, leading to adverse short- and long-term outcomes. Emerging data reveal that even early or brief cannabis exposure during pregnancy is associated with fetal growth restriction, altered neurodevelopmental trajectories, and increased long-term risk for obesity, diabetes, and cardiovascular disease. This mini review provides a conceptual overview of evidence from preclinical and clinical studies, providing understanding of how prenatal cannabis use impacts maternal physiology and fetal development across multiple organ systems.