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Women’s health and midwifery
Cannabis use in pregnancy: a harm reduction approach is needed with a focus on prevention and positive intervention
  1. Cindy-Lee Dennis1,2,
  2. Simone Vigod3
  1. 1 Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
  2. 2 St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
  3. 3 Department of Psychiatry, Women's College Hospital and Research Institute, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Professor Cindy-Lee Dennis, Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada; cindylee.dennis{at}

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Commentary on: Corsi DJ, Walsh L, Weiss D, et al. Association between self-reported prenatal cannabis use and maternal, perinatal, and neonatal outcomes. JAMA 2019;322:145–52.

Implications for practice and research

  • Pregnant and pregnancy-planning women and their partners require education about the potential for increased risk of a preterm birth and other adverse perinatal outcomes following in-utero exposure to cannabis.

  • Future research examining the impact of the specific timing of cannabis exposure and whether there is a dose–response relationship between exposure and outcomes will serve to help determine causality.


Cannabis use is increasing in North America among young people aged 15 to 24 years including women who are pregnant. With recent legalisation in multiple jurisdictions, and discussion about its medical benefits for a variety of conditions, it is anticipated that cannabis use may further increase during pregnancy. Cannabinoids can readily cross the placenta and may disrupt the complex fetal endogenous cannabinoid signalling system. This may lead to adverse pregnancy outcomes. Previous studies have varied in methodology and treatment of confounding …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.