Fetal Exposure to Tobacco and Cannabis

Tobacco and cannabis are the most commonly used legal and illegal substances among pregnant women in the United States, respectively. About 12% to 25% of women smoke tobacco during pregnancy. Smoking tobacco during pregnancy and maternal exposure to environmental tobacco smoke during pregnancy is associated with a variety of adverse fetal outcomes. About 11% of women of childbearing age reported using cannabis in the preceding month. Fetal exposure to tobacco or cannabis is associated with dysregulation in development and may indicate a higher risk for neurodevelopmental and other psychiatric problems. As research has become more sophisticated, findings suggest that some of the associations between fetal exposure to cannabis and tobacco and adverse outcomes may be due to familial genetic risk factors. Separating environmental, familial, and genetic factors while disentangling their interactive effects on fetal and offspring development and neurobehavioral regulation remains a challenge in this field of study.