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Pharmacol Ther. 2018 Feb;182:133-151. doi: 10.1016/j.pharmthera.2017.08.014. Epub 2017 Aug 25.

Cannabis use during pregnancy: Pharmacokinetics and effects on child development.

Author information

1
Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Center on Human Development and Disability, University of Washington, Seattle, WA, USA; Washington National Primate Research Center, University of Washington, Seattle, WA, USA. Electronic address: ksg@uw.edu.
2
Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
3
Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA, USA.
4
Department of Pharmacology, School of Medicine, University of Washington, Seattle, WA, USA; Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
5
Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Center on Human Development and Disability, University of Washington, Seattle, WA, USA; Washington National Primate Research Center, University of Washington, Seattle, WA, USA.

Abstract

The broad-based legalization of cannabis use has created a strong need to understand its impact on human health and behavior. The risks that may be associated with cannabis use, particularly for sensitive subgroups such as pregnant women, are difficult to define because of a paucity of dose-response data and the recent increase in cannabis potency. Although there is a large body of evidence detailing the mode of action of Δ9-tetrahydrocannabinol (THC) in adults, little work has focused on understanding how cannabis use during pregnancy may impact the development of the fetal nervous system and whether additional plant-derived cannabinoids might participate. This manuscript presents an overview of the historical and contemporary literature focused on the mode of action of THC in the developing brain, comparative pharmacokinetics in both pregnant and nonpregnant model systems and neurodevelopmental outcomes in exposed offspring. Despite growing public health significance, pharmacokinetic studies of THC have focused on nonpregnant adult subjects and there are few published reports on disposition parameters during pregnancy. Data from preclinical species show that THC readily crosses the placenta although fetal exposures appear lower than maternal exposures. The neurodevelopmental data in humans and animals suggest that prenatal exposure to THC may lead to subtle, persistent changes in targeted aspects of higher-level cognition and psychological well-being. There is an urgent need for well-controlled studies in humans and preclinical models on THC as a developmental neurotoxicant. Until more information is available, pregnant women should not assume that using cannabis during pregnancy is safe.

KEYWORDS:

Cannabis; Child development; Exposure; Pharmacokinetics; Pregnancy

PMID:
28847562
PMCID:
PMC6211194
DOI:
10.1016/j.pharmthera.2017.08.014
[Indexed for MEDLINE]
Free PMC Article

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