Obstetrician–gynecologists should be discouraged from prescribing or suggesting the use of marijuana for medicinal purposes during preconception, pregnancy, and lactation. Pregnant women or women contemplating pregnancy should be encouraged to discontinue use of marijuana for medicinal purposes in favor of an alternative therapy for which there are better pregnancy-specific safety data.
There are insufficient data to evaluate the effects of marijuana use on infants during lactation and breastfeeding, and in the absence of such data, marijuana use is discouraged.
Notably, 34–60% of marijuana users continue use during pregnancy, with many women believing that it is relatively safe to use during pregnancy and less expensive than tobacco
It is difficult to be certain about the specific effects of marijuana on pregnancy and the developing fetus, in part because those who use it often use other drugs as well, including tobacco, alcohol, or illicit drugs, and in part because of other potential confounding exposures. Marijuana smoke contains many of the same respiratory disease-causing and carcinogenic toxins as tobacco smoke, often in concentrations several times greater than in tobacco smoke.
Studies of marijuana exposure during pregnancy are potentially subject to reporting and recall bias, often relying on self-reported habits, including frequency, timing, and amount of marijuana use.
women using marijuana at least weekly during pregnancy were significantly more likely to give birth to a newborn less than 2,500
Several studies noted statistically significantly smaller birth lengths and head circumferences as well as lower birth weights among exposed offspring
Prenatal exposure to marijuana has been shown to be predictive of psychotic symptoms in young adulthood.
Monitoring the Future survey reported a five-year decline in the perceived harm of regularly smoking marijuana, from 52.4% of high school seniors to 36.1%
Marijuana is the most widely used illegal drug in the United States and it is estimated that it is used by 61% of all persons suffering from a substance use disorder related to drugs other than alcohol.
The risk of developing addiction associated with cannabis use has been reported to increase to about 17% among those who start using marijuana in adolescence, and to 25-50% among those who smoke marijuana daily.
Smoke from marijuana combustion has been shown to contain a number of carcinogens and cocarcinogens, as well as many of the toxins, irritants, and carcinogens as tobacco smoke.
Marijuana-infused edibles account for 45% of the legal marijuana marketplace.
AMA Marijuana has a high potential for abuse. It has no scientifically proven, currently accepted medical use for preventing or treating any disease process in the United States.
Conclusions and relevance: This study suggests that prenatal cannabis exposure and its correlated factors are associated with greater risk for psychopathology during middle childhood. Cannabis use during pregnancy should be discouraged.
Highlights
• PCE may impact fetal growth, with no evidence of long-term effects on size.
• Subtle effects on cognition are supported by neuroimaging and rodent studies.
• PCE is associated with direct effects on behavior and brain function.
• PCE has indirect effects on adult functioning via early initiation of cannabis use.
Research has found that prenatal cannabis use may adversely affect fetal growth and neurodevelopment, be associated with future learning and behavioral problems in children, and increase risk of neonatal morbidity. (Cornelius et al., 2002; Day et al., 1994; El Marroun et al., 2011; Fried and Smith, 2001; Fried et al., 1999; Fried et al., 2003; Fried et al., 1997; Goldschmidt et al., 2000; Goldschmidt et al., 2008; Goldschmidt et al., 2012; Metz et al., 2017; Noland et al., 2005; Willford et al., 2010; Ryan et al., 2018; El Marroun et al., 2018) Several US organizations, including the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics, recommend abstinence from cannabis use during pregnancy. (Ryan et al., 2018; Gynecologists, T.A.C.O.O.A, 2020) Despite these recommendations, there are concerns that the trend of cannabis use during pregnancy will continue to increase as more states and countries legalize cannabis and allow for commercial sales through dispensaries. (Mark and Terplan, 2017)
Results
Rates of reported cannabis use in pregnancy increased from 1.3% to 7.5% over the study period with no appreciable change in slope after legalisation in 2018. Infants of mothers reporting cannabis use in pregnancy were more likely to have major anomalies and a 5-minute Apgar score ≤ 7, require NICU admission, and had lower birth weight, head circumference, and birth length than infants of mothers not reporting cannabis use. These associations did not differ before and after legalisation.
Conclusions
Reported cannabis use during pregnancy is associated with early postnatal complications and reduced fetal growth, even after taking into account a range of confounding factors. Rates of reported cannabis use during pregnancy increased over the past five years in Nova Scotia with no apparent additional effect of legalisation.
Though research among pregnant women and marijuana-exposed neonates is limited, there is evidence to suggest that marijuana use may increase the risk of stillbirth and is associated with neurodevelopmental deficits in the infant.
Evidence-based programs to prevent initiation of marijuana use should target women of childbearing age.
In addition, THC passes from mother to baby through breastmilk; thus, cessation should continue post-partum.
In human studies, the preponderance of evidence suggests that prenatal cannabinoid exposure is predictive of several adverse neonatal outcomes, most notably FGR Fetal growth restriction and LBW low birth weight.
There is thus an urgent need to better understand the mechanistic links between these prenatal developmental events, their impact upon neurodevelopmental pathology and risk factors and how exposure to cannabinoids might synergistically modulate these complex interrelationships.
Maternal cannabis use in pregnancy and child neurodevelopmental outcomes We link pregnancy and birth data to provincial health administrative databases to ascertain child neurodevelopmental outcomes. We use matching techniques to control for confounding and Cox proportional hazards regression models to examine associations between prenatal cannabis use and child neurodevelopment.
Very scientific and medical article.
Early detection and alerting pregnant women about the risks of cannabis use during pregnancy is one way to minimize its possible harm. ..An active involvement is required from primary care, obstetricians, pediatric, mental health and drug dependence services
Consumption of cannabis during pregnancy results in cannabinoid placental crossing and accumulation in the fetal brain, and other organs, where it interferes with neurodevelopment and the endocannabinoid system. Use during the postnatal period can also lead to secretion in breast milk for extended periods (up to a week) after last use. From retrospective studies, we know prenatal cannabis ingestion has been associated with anemia in the mothers as well as low birth weights, greater risk of preterm and stillbirths, as well as increased need for neonatal intensive care unit admissions.
Cannabis effects on fetal growth (eg, low birth weight and length) may be more pronounced in women who consume marijuana frequently, especially in the first and second trimesters.4 This study highlights the importance of screening and interventions for cannabis use among all pregnant women.
This study highlights the importance of screening and interventions for cannabis use among all pregnant women.
Significant effects of prenatal cannabis exposure have been found on children's sleep, cognitive functions (memory and scholastic skills), as well as on executive (frontal lobe) functions (reasoning, attention, impulsivity, and motivation), and affective (depression) and anxiety symptoms throughout the stages of development. Following the presentation of two case vignettes, we integrate the published information on outcomes of maternal use of cannabis during pregnancy on the developing fetus and the "soft" neurological deficits and neuro-behavioral disturbances manifested by them from early childhood and evolving to peaks in adolescence. Taken together, these data serve to define what we call a heretofore unspecified "fetal cannabis spectrum disorder".
Researchers say psychoactive compounds in marijuana easily cross the placenta, exposing the fetus to perhaps 10 percent of the THC — tetrahydrocannabinol — that the mother receives, and higher concentrations if the mom uses pot repeatedly.
Large-scale, longitudinal studies of humans whose mothers smoked marijuana once or more per week and experimental work on rodents exposed to cannabinoids in utero have yielded remarkably consistent intellectual and behavioral correlates of fetal exposure to this drug. Some exposed individuals exhibit deficits in memory, cognition, and measures of sociability. These aberrations appear during infancy and persist through adulthood and are tied to changes in the expression of multiple gene families, as well as more global measures of brain responsiveness and plasticity. Researchers currently consider these perturbations to be mediated by changes to the endocannabinoid system caused by the active compounds in cannabis.
There was more alarming news. Use of illegal drugs, including cocaine, marijuana, and opioids by pregnant women increased significantly between 2015 and 2017. About 7 percent of pregnant women reported using marijuana. Three percent said they used it daily.
McCance-Katz says marijuana use is linked to fetal growth problems, preterm births, stillbirths, hyperactivity and impaired cognition in newborns.
The importance of the published findings and the emerging research regarding the potential negative effects of marijuana on brain development are a cause for concern despite the limited research and are the basis for the following recommendations:
Women who are considering becoming pregnant or who are of reproductive age need to be informed about the lack of definitive research and counseled about the current concerns regarding potential adverse effects of THC use on the woman and on fetal, infant, and child development. Marijuana can be included as part of a discussion about the use of tobacco, alcohol, and other drugs and medications during pregnancy.
As part of routine anticipatory guidance and in addition to contraception counseling, it is important to advise all adolescents and young women that if they become pregnant, marijuana should not be used during pregnancy.
Pregnant women who are using marijuana or other cannabinoid-containing products to treat a medical condition or to treat nausea and vomiting during pregnancy should be counseled about the lack of safety data and the possible adverse effects of THC in these products on the developing fetus and referred to their health care provider for alternative treatments that have better pregnancy-specific safety data.
Women of reproductive age who are pregnant or planning to become pregnant and are identified through universal screening as using marijuana should be counseled and, as clinically indicated, receive brief intervention and be referred to treatment.
Although marijuana is legal in some states, pregnant women who use marijuana can be subject to child welfare investigations if they have a positive marijuana screen result. Health care providers should emphasize that the purpose of screening is to allow treatment of the woman’s substance use, not to punish or prosecute her.
Present data are insufficient to assess the effects of exposure of infants to maternal marijuana use during breastfeeding. As a result, maternal marijuana use while breastfeeding is discouraged. Because the potential risks of infant exposure to marijuana metabolites are unknown, women should be informed of the potential risk of exposure during lactation and encouraged to abstain from using any marijuana products while breastfeeding.
Pregnant or breastfeeding women should be cautioned about infant exposure to smoke from marijuana in the environment, given emerging data on the effects of passive marijuana smoke.
Women who have become abstinent from previous marijuana use should be encouraged to remain abstinent while pregnant and breastfeeding.
Further research regarding the use of and effects of marijuana during pregnancy and breastfeeding is needed.
Pediatricians are urged to work with their state and/or local health departments if legalization of marijuana is being considered or has occurred in their state to help with constructive, nonpunitive policy and education for families.
CBD oil may potentially interact in a negative way with anti-epilepsy drugs. As of now, only in vitro (test tube) observations exist with no living organism testing proving safety. Drugs that may interact include:
Researchers had two women conduct "mystery caller" phone conversations with employees at 400 dispensaries across the state, telling them that they were eight weeks pregnant and suffering from morning sickness. During the majority of those calls, the employees recommended the women use cannabis products.
They also discovered that prenatal marijuana use was associated with a 50 percent increased chance of low birth weight regardless of tobacco use during pregnancy. “Growing evidence suggests prenatal cannabis exposure has a detrimental impact on offspring brain function starting in the toddler years, specifically issues related to attention deficit disorder,” Crume said. “But much of the research on the effects of prenatal cannabis on neonatal outcomes was based on marijuana exposures in the 1980s and 1990s which may not reflect the potency of today’s cannabis or the many ways it is used.”
1. Legalizing cannabis has been shown to increase the rates of motor vehicle accidents.
2. Cannabis use is a risk factor for mental illness.
3. Inhaled Cannabis use is a risk factor for respiratory infections.
4. Cannabis use increases the rate of vascular disease. Cannabis is the third most often identified drug of abuse
5. Cannabis use during pregnancy has been associated with increased risk of adverse birth outcomes
6. Legalization of cannabis has been shown to increase cannabis exposure in the pediatric population.
7. Heavy cannabis use is associated with diminished lifetime achievements.
Doctors must educate the public about the potential harm cannabis causes with heavy, and possibly moderate, widespread use just as they do about the dangers of tobacco use. Tobacco use has declined in the United States in large part because of the knowledge the public now holds about its adverse effects, as opposed to legislative action.
In a new study, researchers in London, Ontario found that women who used marijuana while pregnant were almost three times more likely to have an infant with low birth weight than women who did not use marijuana.
Marijuana use during pregnancy can be harmful to your baby’s health. The chemicals in marijuana (in particular,tetrahydrocannabinol or THC) pass through your systemto your baby and can negatively affect your baby’s development.
Smoking marijuana can lead to a greater risk of bronchitis, cough, and phlegm production.
Marijuana users are significantly more likely than nonusers to develop chronic mental disorders, including schizophrenia. Schizophrenia is a type of mental illness where people might see or hear things that aren't really there (hallucinations).
Eating foods or drinking beverages that contain marijuana have some different risks than smoking marijuana, including a greater risk of poisoning.
About 1 in 10 marijuana users will become addicted. For people who begin using before the age of 18, that number rises to 1 in 6.
Some research shows that using marijuana while you are pregnant[288 KB] can cause health problems in newborns—including low birth weight and developmental problems.
Marijuana use can slow your reaction time and ability to make decisions when driving[271 KB].
Connection between legalization of marijuana and increase opioid addiction.
The effects of marijuana on the brain of an unborn child. Predisposing children for addiction. Here are the studies cited.
Alcohol use during pregnancy can cause fetal alcohol spectrum disorders (FASDs), which are physical, behavioral, and intellectual disabilities that last a lifetime. FASD is 100% preventable.
Summary: Cannabis use during pregnancy is associated with abnormal brain structure in children, according to a new study. Compared with unexposed children, those who were prenatally exposed to cannabis had a thicker prefrontal cortex, a region of the brain involved in complex cognition, decision-making, and working memory.
For the researchers of the study, the results present a “a major public health concern” as a number of pregnant women would report taking marijuana to alleviate morning sickness or nausea – without knowing of the adverse side-effects.
Children whose mothers use marijuana during pregnancy have a higher risk of stunted growth and of developing ADHD, anxiety, and depression later in life.
When THC enters the body, it interferes with endocannabinoid’s actions, competing with it for binding sites on target cells and generally getting its way.
My main finding is that it's primarily women who were younger when they become mothers who do continue to use marijuana overtime. Also women who are depressed over longer periods of time, women who smoke, women who use more than the recommended amount of alcohol are more likely to continue to use marijuana while pregnant as well as when they're raising their children. So the take-home messages is to ask women about marijuana use. We know that marijuana use is considered more and more acceptable by women and that they may continue to use while they are pregnant and while they are having children.
Given these statistics.... is legalization worth the consequences....
Cannabis has been found to be the most frequently used drug in the U.S. after alcohol, tobacco and caffeine.
The risk of developing addiction associated with cannabis use has been reported to increase to about 17% among those who start using marijuana in adolescence, and to 25-50% among those who smoke marijuana daily.
The long-term effects of marijuana use include altered brain development and cognitive impairment, including impaired neural connectivity in specific brain regions, decreased activity in prefrontal regions, and reduced volumes in the hippocampus.
Cannabis is most commonly consumed through smoking, a route of drug delivery that predictably has a variety of negative effects on pulmonary function. Smoke from marijuana combustion has been shown to contain a number of carcinogens and cocarcinogens, as well as many of the toxins, irritants, and carcinogens as tobacco smoke. Additionally, marijuana smokers tend to inhale more deeply and hold their breath longer than cigarette smokers, which leads to a greater exposure per breath to “tar” (the carcinogenic solids in smoke). Regular smoking of marijuana, in the absence of tobacco, produces visible and microscopic injury to the large airways http://www.asam.org/docs/default-source/publicy-policy-statements/mariju...
Studies show that children exposed to marijuana in utero have lower scores on tests of visual problem-solving, visual and motor coordination, and visual analysis, compared with children not exposed to the drug, the report states. Prenatal marijuana exposure also has been associated with decreased attention span and behavioral problems. The nervous system of a human fetus can respond to the chemicals in marijuana within 14 weeks of gestation, and studies have shown that 14-year-olds are more likely to be marijuana users if their mothers used the drug during pregnancy.
"We found moderate evidence that maternal use of marijuana during pregnancy is associated with negative effects on exposed offspring, including decreased academic ability, cognitive function and attention. Importantly, these effects may not appear until adolescence.
State of the Science 190 resources
Several problems are associated with marijuana use during pregnancy, because prenatal exposure influences brain development and can result in permanent cognitive impairment. [35] Cognitive deficits resulting from prenatal exposure include inattention; impulsivity; and impairment in learning, memory, and certain aspects of executive functioning. [36] In addition, prenatal exposure to cannabis has been associated with reduction of fetal growth. [37]
For many years, the myth of smoked cannabis being "healthier" or "no worse" than smoked tobacco was perpetuated by promarijuana groups. Both smoked cannabis and tobacco contain approximately 4000 chemicals and that these chemicals are essentially identical in both plants.In another recent review, [23] the authors concluded that "smoking of cannabis is not medically recommended due to the potential respiratory tract, dangers of noxious compounds such as polycyclic aromatic hydrocarbons, tar and carbon monoxide."
Therefore, disrupted temporal and/or spatial precision of cannabinoid receptor activation, especially due to in utero cannabis exposure, can destabilize finely tuned signalling networks resulting in altered brain circuit formation and sensitivity to secondary insults.
cannabis use during pregnancy can increase the risk for ill‐behaviors (Goldschmidt et al, 2004; Day et al, 2011
Data suggest that administration of THC during pregnancy can induce long‐term structural and functional modifications of the cortical circuitry. Maternal cannabis use during pregnancy reduces SCG10 in human fetal cerebrum
Recent attention has been focused on the long-term impact of cannabis exposure, for which experimental animal studies have validated causal relationships between neurobiological and behavioral alterations during the individual's lifetime.
Cannabis has enormous affinity for milk and produces a milk/plasma ratio of 8, although the levels in milk are generally considered subclinical. THC crosses the placenta readily, and there is increasing evidence that it may increase rates of growth retardation and adverse neurodevelopment following prenatal exposure.
One study indicated an increased incidence of reduced head circumference in young adolescents (9-12 years of age) who were exposed in utero to heavy marijuana use. Prenatal exposure resulted in a higher rate of low birth weight infants and childhood leukemia. Recent studies have suggested a reduction in long and short-term memory retrieval and retention in children exposed to prenatal cannabis. These children were also weak in planning, integration, and judgment skills.
While the effect of cannabis on infants from breastfeeding mothers is limited, cannabis use in breastfeeding mothers should be strongly discouraged. Thus, in pregnant and breastfeeding mothers, this drug should no longer be viewed as safe.
Records for 24,874 women: The results of this study show that the use of cannabis in pregnancy is associated with increased risk of adverse birth outcomes. Prevention programs that address cannabis use during pregnancy are needed.
Multivariate analysis, controlling for potential confounders, including tobacco smoking, alcohol consumption, and use of other illicit drugs, showed that cannabis use in pregnancy was associated with low birth weight, preterm labor, small for gestational age, and admission to the neonatal intensive care unit.
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