{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T10:04:27Z","timestamp":1783073067605,"version":"3.54.6"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Cannabis use among pregnant women has increased over time. Therefore, there is a great public health need to understand the consequences of <jats:italic>in utero<\/jats:italic> cannabis exposure. While several meta-analyses and reviews have summarized the evidence of <jats:italic>in utero<\/jats:italic> cannabis exposure on adverse obstetric outcomes (e.g., low birth weight and preterm birth) and long-term offspring development, there has not been a focus on <jats:italic>in utero<\/jats:italic> cannabis exposure and risk for structural birth defects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a systematic review using PRISMA guidelines to evaluate the association between <jats:italic>in utero<\/jats:italic> cannabis exposure and structural birth defects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 20 articles to include in our review and focused on interpreting findings from the 12 that adjusted for potential confounders. We report findings by seven organ systems. Within the 12 articles, four reported on cardiac malformations, three reported on central nervous system malformations, one reported on eye malformations, three reported on gastrointestinal malformations, one reported on genitourinary malformations, one reported on musculoskeletal malformations, and two reported on orofacial malformations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Findings on associations between <jats:italic>in utero<\/jats:italic> cannabis exposure and birth defects reported in more than two articles were mixed (i.e., findings for cardiac, gastrointestinal, central nervous system malformations). Findings for associations between <jats:italic>in utero<\/jats:italic> cannabis exposure and birth defects reported in two articles (i.e., orofacial malformations) or in a single article (eye, genitourinary, and musculoskeletal) suggested that cannabis exposure was not associated with these types of malformations, but strong conclusions cannot be drawn from such sparce research. We review the limitations and gaps in the existing literature and call for more research to rigorously evaluate associations between <jats:italic>in utero<\/jats:italic> cannabis exposure and structural birth defects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p>identifier CRD42022308130.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2023.1149401","type":"journal-article","created":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T04:39:28Z","timestamp":1684989568000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["A systematic review of in utero cannabis exposure and risk for structural birth defects"],"prefix":"10.3389","volume":"11","author":[{"given":"Ayesha C.","family":"Sujan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anish","family":"Pal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyndsay A.","family":"Avalos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly C.","family":"Young-Wolff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1001\/jama.2019.7982","article-title":"Self-reported medical and nonmedical Cannabis use among pregnant women in the United States","volume":"322","author":"Volkow","year":"2019","journal-title":"JAMA"},{"key":"B2","author":"Geiger","year":"2016"},{"key":"B3","year":"2017"},{"key":"B4","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1055\/s-0039-1696719","article-title":"Impact of marijuana legalization on prevalence of maternal marijuana use and perinatal outcomes","volume":"37","author":"Gnofam","year":"2020","journal-title":"Am J Perinatol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17030909","article-title":"Recreational Cannabis legalization in the US and maternal use during the preconception, prenatal, and postpartum periods","volume":"17","author":"Skelton","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.0138","article-title":"Association of recreational Cannabis legalization with maternal Cannabis use in the preconception, prenatal, and postpartum periods","volume":"4","author":"Skelton","year":"2021","journal-title":"JAMA Netw Open"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e210694","DOI":"10.1001\/jamanetworkopen.2021.0694","article-title":"Association of cannabis retailer proximity and density with cannabis use among pregnant women in northern California after legalization of cannabis for recreational use","volume":"4","author":"Young-Wolff","year":"2021","journal-title":"JAMA Netw Open"},{"key":"B8","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1111\/ppe.12505","article-title":"Effects of prenatal marijuana exposure on neuropsychological outcomes in children aged 1\u201311 years: a systematic review","volume":"32","author":"Sharapova","year":"2018","journal-title":"Paediatr Perinat Epidemiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1002\/bdra.10145","article-title":"Maternal lifestyle factors and risk for ventricular septal defects","volume":"70","author":"Williams","year":"2004","journal-title":"Birth Defects Res A Clin Mol Teratol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3389\/fpsyt.2020.624275","article-title":"Prenatal cannabinoid exposure: emerging evidence of physiological and neuropsychiatric abnormalities","volume":"11","author":"Nashed","year":"2021","journal-title":"Front Psychiatry"},{"key":"B11","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s12978-020-0880-9","article-title":"Cannabis use during pregnancy and its relationship with fetal developmental outcomes and psychiatric disorders. 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