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.

广泛使用大麻的合法化已经引起了对了解其对人类健康和行为的影响的强烈需求。由于缺乏剂量反应数据以及最近大麻药效增强，很难确定与使用大麻有关的风险，特别是对于诸如孕妇等敏感亚群的大麻。虽然有大量的证据，详细Δ的作用模式⁹-成年人中的四氢大麻酚（THC），很少有工作致力于了解怀孕期间使用大麻如何影响胎儿神经系统的发育以及其他植物来源的大麻素是否可能参与。该手稿介绍了历史和当代文学的概述，这些文学集中于THC在发育中的大脑中的作用方式，孕妇和非孕妇模型系统中的比较药代动力学以及裸露后代的神经发育结局。尽管对公众健康的重要性日益提高，但四氢大麻酚的药代动力学研究集中于未怀孕的成人受试者，关于妊娠期间性状参数的公开报道很少。来自临床前物种的数据表明，尽管胎儿暴露量似乎低于母体暴露量，但四氢大麻酚很容易穿过胎盘。人和动物的神经发育数据表明，产前暴露于THC可能导致高水平认知和心理健康的目标方面发生细微而持续的变化。迫切需要在人类和临床前模型上进行良好控制的研究，以THC作为发育性神经毒性药物。在没有更多信息可用之前，孕妇不应假定怀孕期间使用大麻是安全的。