Argote Mathilde, Hilson Leah, Sorkhou Maryam, Rabin Rachel A
McGill University, Montreal, Canada.
The Douglas Mental Health University Institute, Verdun, Canada.
Drug Alcohol Depend Rep. 2025 Aug 29;17:100376. doi: 10.1016/j.dadr.2025.100376. eCollection 2025 Dec.
Despite the high and increasing rates of cannabis and nicotine/tobacco product (NTP) use during pregnancy, the impact of their combined use on health outcomes in offspring remains poorly understood. Given the growing body of research on prenatal cannabis and NTP co-exposure and its effects on neonatal, behavioral, cognitive, and physiological outcomes in offspring, we conducted a systematic review to synthesize the existing literature and evaluate whether prenatal co-exposure results in additive and/or synergistic adverse effects compared to prenatal cannabis-only exposure and prenatal NTP-only exposure.
We searched Medline, Embase, and PsycINFO databases via OVID for human and animal studies examining the association between prenatal co-exposure and single-substance exposure on neonatal, behavioral, cognitive, and physiological outcomes in offspring.
Of 3217 records identified, 46 articles were included in the review (human, n = 43; preclinical n = 3). For select neonatal outcomes, co-exposed infants exhibited a higher risk of compromised physical development and birth defects relative to infants with single-substance exposure. Behavioral outcomes, particularly emotion regulation/reactivity, and physiological outcomes demonstrated a similar pattern. In contrast, other neonatal outcomes (e.g., preterm birth and respiratory distress), and cognition were similar between the prenatal co-exposure and single-substance exposure groups.
This review suggests additive and/or synergistic adverse consequences associated with co-exposure on several outcomes in offspring relative to single substance exposure. These findings highlight the urgent need for prevention and treatment strategies addressing cannabis and NTP use in pregnant women. We discuss the limitations of the included studies and highlight key areas for future research.
尽管孕期大麻及尼古丁/烟草制品（NTP）的使用率居高不下且呈上升趋势，但其联合使用对后代健康结局的影响仍知之甚少。鉴于关于产前大麻与NTP共同暴露及其对后代新生儿、行为、认知和生理结局影响的研究日益增多，我们进行了一项系统综述，以综合现有文献，并评估与仅产前暴露于大麻和仅产前暴露于NTP相比，产前共同暴露是否会导致相加和/或协同的不良影响。
我们通过OVID在Medline、Embase和PsycINFO数据库中检索了关于产前共同暴露与单一物质暴露对后代新生儿、行为、认知和生理结局影响的人类和动物研究。
在识别出的3217条记录中，46篇文章被纳入综述（人类研究，n = 43；临床前研究，n = 3）。对于特定的新生儿结局，与单一物质暴露的婴儿相比，共同暴露的婴儿出现身体发育受损和出生缺陷的风险更高。行为结局，特别是情绪调节/反应性，以及生理结局呈现出类似的模式。相比之下，产前共同暴露组和单一物质暴露组之间的其他新生儿结局（如早产和呼吸窘迫）以及认知情况相似。
本综述表明，与单一物质暴露相比，共同暴露会对后代的多种结局产生相加和/或协同的不良后果。这些发现凸显了针对孕妇使用大麻和NTP制定预防和治疗策略的迫切需求。我们讨论了纳入研究的局限性，并强调了未来研究的关键领域。
