Cannabinoid exposure during pregnancy: Cardiorespiratory effects and offspring outcomes

Cannabinoid use during pregnancy has risen worldwide in recent years, driven by both recreational use and perceived therapeutic benefits. While most existing research has concentrated on neuropsychiatric outcomes and structural or functional changes in the offspring's forebrain regions, comparatively little attention has been given to the potential effects on cardiorespiratory control. This gap is important, as prenatal exposure to cannabinoids may disrupt the development of neural circuits responsible for autonomic and respiratory functions, including brainstem networks, potentially resulting in long-lasting changes in ventilatory responses, cardiovascular regulation and homeostatic reflexes. Understanding these effects is especially vital due to the role of the endocannabinoid system in modulating neuronal excitability, neurotransmission and developmental processes. This review synthesises current evidence from both clinical and experimental studies, emphasising the mechanisms by which prenatal cannabinoid exposure could influence cardiorespiratory physiology in a sex-dependent manner, identifying key methodological limitations in the field and gaps in the literature, and proposing future research directions to fill this knowledge gap.