{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T22:05:06Z","timestamp":1793397906006,"version":"4.5.0"},"reference-count":188,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Erasmus MC - Sophia Children\u2019s Hospital","award":["WAR23-28"],"award-info":[{"award-number":["WAR23-28"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The use of cannabis during pregnancy is increasing, in line with its growing societal acceptance and legalization. Cannabis use mainly concerns its active components \u03949-tetrahydrocannabinol (THC) and cannabidiol (CBD). While cannabis has therapeutic effects on pain, nausea, and vomiting, its impact on fetal development remains a significant public health concern. Given the existence of a local endocannabinoid system (ECS) in the placenta, with proven effects on placental development and blood flow, it is likely that THC and CBD exert effects via interference with the placental ECS. This review summarizes how cannabis use affects the placental ECS and describes the consequences of such use on placental function and fetal development. It starts with discussing the placental ECS, the effects of THC and CBD on placental function, and the pharmacokinetics of cannabinoids during pregnancy. It then describes the effects of both paternal and maternal cannabis use and provides epidemiological data linking placental insufficiency, impaired fetal growth, and preeclampsia to cannabis use. It also raises awareness for the possibility that cannabis use, by altering DNA methylation, might result in transgenerational effects. It is concluded that current evidence supports abstaining from cannabis use during preconception, pregnancy, and lactation to optimize maternal, fetal, and intergenerational health outcomes.<\/jats:p>","DOI":"10.3390\/ijms27031398","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T17:38:34Z","timestamp":1769794714000},"page":"1398","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Recreational Cannabis Use During Human Pregnancy: Its Effects on the Placenta and Endocannabinoid System"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5814-1103","authenticated-orcid":false,"given":"Madhavi S.","family":"Harhangi","sequence":"first","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands"},{"name":"Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands"},{"name":"Department of Obstetrics and Gynaecology, Division of Obstetrics and Fetal Medicine, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8723-4405","authenticated-orcid":false,"given":"Lisa","family":"H\u00f6fert","sequence":"additional","affiliation":[{"name":"Institute of Legal Medicine, Medical Faculty, University of Leipzig, 04109 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5052-3585","authenticated-orcid":false,"given":"A. H. Jan","family":"Danser","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5800-8051","authenticated-orcid":false,"given":"Hilmar H.","family":"Bijma","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Division of Obstetrics and Fetal Medicine, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5219-5696","authenticated-orcid":false,"given":"Sinno H. P.","family":"Simons","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irwin K. M.","family":"Reiss","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands"},{"name":"Division of Neonatology and Pediatric Intensive Care, University Children\u2019s Hospital Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3453-5308","authenticated-orcid":false,"given":"Sven","family":"Baumann","sequence":"additional","affiliation":[{"name":"Institute of Legal Medicine, Medical Faculty, University of Leipzig, 04109 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4736-398X","authenticated-orcid":false,"given":"Michelle","family":"Broekhuizen","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands"},{"name":"Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.jpag.2019.03.004","article-title":"What Every Pediatric Gynecologist Should Know About Marijuana Use in Adolescents","volume":"32","author":"Chadi","year":"2019","journal-title":"J. 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