Prenatal cannabis exposure and infant neurodevelopment: A scoping review of evidence and methodological gaps

Cannabis use during the perinatal period continues to rise, yet its impacts on infant neurodevelopment remain unclear. With increasing cannabis potency, diverse ingestion methods, and unresolved confounding, refined study designs are needed to clarify these associations.

This scoping review aimed to synthesize evidence on perinatal cannabis exposure and infant neurodevelopment, focusing on reported outcomes, covariates and confounders, and how exposure was defined and measured.

We reviewed literature from January 2013 to September 2025 across five databases (CINAHL, EMBASE, MEDLINE, PsycINFO, Web of Science) guided by PRISMA-ScR guidelines. Studies were included if they examined the association between perinatal cannabis exposure and infant neurodevelopment. Data extraction was guided by a biopsychosocial model and addressed reproductive variables, and data synthesis was conducted using a narrative synthesis approach.

A total of 2137 records were screened, with 12 studies included. Two studies found that prenatal cannabis exposure were associated with poorer self-regulation and visual processing outcomes. Ten studies found no direct associations, though one identified that cannabis exposed infants from low-income households had worse NICU Network Neurobehavioral Scale (NNNS) scores compared to high-income households. Key covariates included child sex, socioeconomic status, maternal comorbidities (e.g. hypertension), maternal anxiety and depression, and gestational age at birth. Few studies captured the multidimensionality of cannabis exposure, with only one quantifying tetrahydrocannabinol (THC) concentration and none assessing the route of use.

Key methodological gaps were identified in studies linking infant neurodevelopment and cannabis exposure. This scoping review offers guidance to enhance the robustness of findings in future empirical research.