Cannabis, the pregnant woman and her child: weeding out the myths

Abstract

To review and summarise the literature reporting on cannabis use within western communities with specific reference to patterns of use, the pharmacology of its major psychoactive compounds, including placental and fetal transfer, and the impact of maternal cannabis use on pregnancy, the newborn infant and the developing child. Review of published articles, governmental guidelines and data and book chapters. Although cannabis is one of the most widely used illegal drugs, there is limited data about the prevalence of cannabis use in pregnant women, and it is likely that reported rates of exposure are significantly underestimated. With much of the available literature focusing on the impact of other illicit drugs such as opioids and stimulants, the effects of cannabis use in pregnancy on the developing fetus remain uncertain. Current evidence indicates that cannabis use both during pregnancy and lactation, may adversely affect neurodevelopment, especially during periods of critical brain growth both in the developing fetal brain and during adolescent maturation, with impacts on neuropsychiatric, behavioural and executive functioning. These reported effects may influence future adult productivity and lifetime outcomes. Despite the widespread use of cannabis by young women, there is limited information available about the impact perinatal cannabis use on the developing fetus and child, particularly the effects of cannabis use while breast feeding. Women who are using cannabis while pregnant and breast feeding should be advised of what is known about the potential adverse effects on fetal growth and development and encouraged to either stop using or decrease their use. Long-term follow-up of exposed children is crucial as neurocognitive and behavioural problems may benefit from early intervention aimed to reduce future problems such as delinquency, depression and substance use.

Prenatal, perinatal, and adolescent exposure to marijuana: Relationships with aggressive behavior

“…637," 2015;Jaques et al, 2014;Warner, Roussos-Ross, & Behnke, 2014). Therefore, use of marijuana during nursing is discouraged in the absence of evidence that it is safe for the newborn (Jaques et al, 2014;Warner et al, 2014).…”

“…THC and its metabolites can be detected in neonatal urine and meconium (Szeto, 1993). However, levels of THC and the metabolite 9-carboxy-THC appear to be much lower in umbilical cord blood than in maternal blood in heavy users (Blackard & Tennes, 1984); no studies have established THC plasma concentrations in the human fetus (Jaques et al, 2014). Mechanisms for potential teratogenic effects of marijuana include complex pharmacologic actions on developing biological systems, altered uterine blood flow, or altered maternal health behavior (Behnke & Smith, 2013).…”

“…Most professional bodies, including the Academy of Breastfeeding Medicine, recommend against breastfeeding whenever illicit drug use has occurred during the 30-day period before birth or if it is ongoing (Jaques et al, 2014;Warner et al, 2014). However, some professionals argue that, depending on family circumstances, among women who find abstaining from marijuana use to be difficult, the benefits of breastfeeding may outweigh the negative sideeffects of marijuana, even with continued use (particularly in infrequent cannabis users) (Hill & Reed, 2013;Jaques et al, 2014).…”

“…However, some professionals argue that, depending on family circumstances, among women who find abstaining from marijuana use to be difficult, the benefits of breastfeeding may outweigh the negative sideeffects of marijuana, even with continued use (particularly in infrequent cannabis users) (Hill & Reed, 2013;Jaques et al, 2014).…”

“…Pre-adult Exposure to Marijuana: Relationships with Aggressive Behavior 12 the quantity and quality of breast milk (Jaques et al, 2014), but there is a dearth of research on effects on nursing infants ("Committee Opinion No. 637," 2015;Jaques et al, 2014;Warner, Roussos-Ross, & Behnke, 2014).…”