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Peer-reviewedCC BY 4.0European Child & Adolescent Psychiatry

Neurodevelopmental outcomes following prenatal cannabinoid exposure: a systematic review

  • Maria Leonor Domingues1
  • Bruno Miguel Fonseca2,3
  • Susana Isabel Sá1,4
4 affiliations
  1. 1Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, 4200-319 Portugal
  2. 2UCIBIO – Applied Molecular Biosciences Unit, Laboratório de Bioquímica, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira 228, Porto, 4050-313 Portugal
  3. 3Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculdade de Farmácia, Universidade do Porto, Porto, 4050-313 Portugal
  4. 4RISE-Health, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, 4200-319 Portugal
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Abstract

Cannabis use during pregnancy is increasing worldwide, yet evidence regarding its long-term neurodevelopmental consequences remains heterogeneous and inconclusive. This systematic review aimed to synthesise observational evidence on the association between prenatal cannabis exposure and neurodevelopmental outcomes from birth to adolescence. A systematic search of PubMed/MEDLINE, Web of Science, and PsycINFO was conducted from database inception to October 2025. Observational studies evaluating neurodevelopmental outcomes following prenatal cannabis exposure were included. Outcomes were grouped by domain and age group. Risk of bias was assessed using the Newcastle-Ottawa Scale. Due to substantial heterogeneity in exposure definitions, outcome measures, and confounder adjustment, findings were synthesised narratively. Seventy-two studies met inclusion criteria. Associations appeared to be domain-specific rather than reflecting global neurodevelopmental impairment. Behavioural dysregulation, attention-related difficulties, and executive functioning showed the most consistent associations with prenatal cannabis exposure, with 73%, 69%, and 70% of studies within these domains reporting negative associations, respectively. In contrast, most studies found no significant associations with global cognition (84%), language (92%), or motor development (60%) after adjustment for confounders. Several cohorts suggested stronger associations with heavier or persistent cannabis exposure after maternal awareness of pregnancy, indicating possible dose-response and timing effects. Current evidence does not consistently support global neurodevelopmental impairment following prenatal cannabis exposure but suggests a pattern of selective vulnerability in behavioural, attention and executive regulatory domains. Together, these findings support cautious clinical counselling and highlight the need for high-quality longitudinal studies with improved exposure and outcome measurements, and rigorous confounder control.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00787-026-03126-z.

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Cite

BibTeXRIS
BibTeX
@article{domingues2026neurodevelopmental,
  title = {{Neurodevelopmental outcomes following prenatal cannabinoid exposure: a systematic review}},
  author = {Maria Leonor Domingues and Bruno Miguel Fonseca and Susana Isabel Sá},
  journal = {European Child \& Adolescent Psychiatry},
  year = {2026},
  month = jul,
  doi = {10.1007/s00787-026-03126-z},
  url = {https://doi.org/10.1007/s00787-026-03126-z},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Neurodevelopmental outcomes following prenatal cannabinoid exposure: a systematic review
AU  - Maria Leonor Domingues
AU  - Bruno Miguel Fonseca
AU  - Susana Isabel Sá
PY  - 2026
DA  - 2026/07/04
JO  - European Child & Adolescent Psychiatry
DO  - 10.1007/s00787-026-03126-z
UR  - https://doi.org/10.1007/s00787-026-03126-z
AB  - Cannabis use during pregnancy is increasing worldwide, yet evidence regarding its long-term neurodevelopmental consequences remains heterogeneous and inconclusive. This systematic review aimed to synthesise observational evidence on the association between prenatal cannabis exposure and neurodevelopmental outcomes from birth to adolescence. A systematic search of PubMed/MEDLINE, Web of Science, and PsycINFO was conducted from database inception to October 2025. Observational studies evaluating neurodevelopmental outcomes following prenatal cannabis exposure were included. Outcomes were grouped by domain and age group. Risk of bias was assessed using the Newcastle-Ottawa Scale. Due to substantial heterogeneity in exposure definitions, outcome measures, and confounder adjustment, findings were synthesised narratively. Seventy-two studies met inclusion criteria. Associations appeared to be domain-specific rather than reflecting global neurodevelopmental impairment. Behavioural dysregulation, attention-related difficulties, and executive functioning showed the most consistent associations with prenatal cannabis exposure, with 73%, 69%, and 70% of studies within these domains reporting negative associations, respectively. In contrast, most studies found no significant associations with global cognition (84%), language (92%), or motor development (60%) after adjustment for confounders. Several cohorts suggested stronger associations with heavier or persistent cannabis exposure after maternal awareness of pregnancy, indicating possible dose-response and timing effects. Current evidence does not consistently support global neurodevelopmental impairment following prenatal cannabis exposure but suggests a pattern of selective vulnerability in behavioural, attention and executive regulatory domains. Together, these findings support cautious clinical counselling and highlight the need for high-quality longitudinal studies with improved exposure and outcome measurements, and rigorous confounder control.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00787-026-03126-z.
SN  - 1018-8827
SN  - 1435-165X
ER  -