Psychedelic exposure in pregnancy: a scoping review to inform perinatal drug safety and clinical counseling.
Therapeutic advances in drug safety January 1, 2026 Ovie Martin Albert, Alexander Arthur
Human evidence on prenatal exposure to psychedelics such as MDMA, LSD, and mescaline is sparse and methodologically limited. A scoping review of 23 primary human studies (1968–2020) found no eligible pregnancy outcome studies for psilocybin or DMT/ayahuasca. The available evidence, mostly small cohorts and case reports, is constrained by self-reported exposure, polysubstance use, and inconsistent outcome definitions. Clinicians should counsel patients with explicit acknowledgment of uncertainty while supporting harm reduction. The absence of data for several substances should not be interpreted as evidence of safety, and structured pharmacovigilance is needed as therapeutic psychedelic research expands.