What are the risks of cannabis (marijuana) use during pregnancy?

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Last updated: April 1, 2025View editorial policy

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From the Guidelines

Marijuana use during pregnancy poses significant risks to the developing baby, including lower birth weight, premature birth, and potential long-term effects on cognitive function, attention, memory, and behavior, and therefore, its use is not recommended. The main psychoactive compound in marijuana, THC, can cross the placenta and reach the fetus, potentially affecting development 1. Risks associated with marijuana use during pregnancy include increased risk of stillbirth and admission to neonatal intensive care. The smoke from marijuana contains many of the same harmful chemicals as tobacco smoke, which can reduce oxygen delivery to the baby. Additionally, marijuana may contain contaminants like pesticides or fungi that could be harmful.

Some studies suggest that marijuana use during pregnancy may have subtle effects on long-term neurobehavioral outcomes 1. However, more recent studies have highlighted the importance of considering the potential risks of marijuana use during pregnancy, particularly in the context of other substance use disorders 1. The endocannabinoid system, which is affected by THC, plays a crucial role in regulating various physiological processes, including nausea and vomiting, and its dysregulation has been implicated in conditions such as cannabinoid hyperemesis syndrome 1.

If you're using marijuana for medical reasons like nausea or anxiety during pregnancy, it's essential to discuss safer FDA-approved alternatives with your healthcare provider. Complete abstinence from marijuana during pregnancy and while breastfeeding is the safest approach for your baby's health and development. Key considerations for healthcare providers include:

  • Screening for marijuana use during pregnancy
  • Counseling patients on the potential risks of marijuana use during pregnancy
  • Discussing safer alternatives for managing nausea and anxiety during pregnancy
  • Monitoring fetal development and birth outcomes in patients who use marijuana during pregnancy

Overall, the potential risks associated with marijuana use during pregnancy outweigh any potential benefits, and its use is not recommended.

From the Research

Risks of Marijuana Use in Pregnancy

The use of marijuana during pregnancy has been associated with several risks, including:

  • Increased risk of fetal growth restriction and adverse neurodevelopmental consequences 2
  • Increased risk of gestational hypertension, gestational weight gain less than or greater than guidelines, and placental abruption 3
  • Increased risk of preterm birth, low birth weight, neonatal intensive care unit admission, and fetal death 3, 4, 5
  • Increased risk of small for gestational age infants 4, 5
  • Impairments in cognitive function and difficulties in behavior in offspring 6
  • Structural and functional alterations in the brain of offspring 6
  • Potential negative effects on mental and emotional well-being 6
  • Negative impact on placental functioning and fetal growth 6

Factors Influencing Risks

The risks associated with marijuana use during pregnancy may be influenced by:

  • Frequency of use: higher frequency of use is associated with greater risks 3, 4
  • Timing of use: use during the second and third trimesters may be associated with higher risks 4
  • Dose of THC: higher doses of THC may be associated with greater risks 2
  • Presence of other substance use: use of other substances may confound the risks associated with marijuana use 2, 4

Current Recommendations

Given the potential risks associated with marijuana use during pregnancy, it is currently recommended to avoid using marijuana while pregnant or breastfeeding 2, 5. Healthcare providers should educate pregnant women about the potential risks of marijuana use and develop strategies to mitigate these risks. Further research is needed to fully understand the effects of marijuana use during pregnancy and to inform public health policy and education initiatives 2, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Marijuana Use in Pregnancy: A Review.

Obstetrical & gynecological survey, 2019

Research

Cannabis and Pregnancy: A Review.

Obstetrical & gynecological survey, 2023

Research

Cannabis Use during Pregnancy: An Update.

Medicina (Kaunas, Lithuania), 2024

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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