Cannabis Use During the Perinatal Period in a State With Legalized Recreational and Medical Marijuana: The Association Between Maternal Characteristics, Breastfeeding Patterns, and Neonatal Outcomes

Crume, Tessa; Juhl, Ashley L.; Brooks‐Russell, Ashley; Hall, Katelyn E.; Wymore, Erica; Borgelt, Laura M.

doi:10.1097/01.ogx.0000547741.96802.c3

Cited by 22 publications

(46 citation statements)

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“…Regarding substance abuse, our finding of nearly half of the adolescents reporting non-illicit substance abuse during pregnancy is in accordance with the literature [17,20]. The finding of a significant impact of substance abuse such as nicotine, cannabis and alcohol use [12][13][14] on birthweight is consistent with current findings in adult mothers. Substance abuse increases the risk of adverse events during pregnancy, and this risk could be a stronger target for preventive efforts.…”

Section: Discussionsupporting

confidence: 92%

“…Substance abuse during pregnancy is strongly associated with reduced birthweight: Maternal nicotine abuse during pregnancy leads to lower birthweightan average decrease of at least 200 g [12]. A significantly lower birthweight was also found to be related to the consumption of alcohol [13] and cannabinoids [14] during pregnancy. Substance abuse during pregnancy is more common in adolescent than in adult women [15].…”

Section: Introductionmentioning

confidence: 96%

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Pregnancy complications, substance abuse, and prenatal care predict birthweight in adolescent mothers

et al. 2021

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Background Reduced birthweight is associated with adverse physical and mental health outcomes later in life. Children of adolescent mothers are at higher risk for reduced birthweight. The current study aimed to identify the key risk factors affecting birthweight in a well-characterized sample of adolescent mothers to inform preventive public health efforts. Methods Sixty-four adolescent mothers (≤ 21 years of age) provided detailed data on pregnancy, birth and psychosocial risk. Separate regression analyses with (1) birthweight and (2) low birthweight (LBW) as outcomes, and pregnancy complications, prenatal care, maternal age, substance abuse during pregnancy, socioeconomic risk, stressful life events and the child’s sex as independent variables were conducted. Exploratively, a receiver operating characteristic (ROC) analysis was performed to investigate the quality of the discriminatory power of the risk factors. Results The following variables explained variance in birthweight significantly: prenatal care attendance (p = .006), pregnancy complications (p = .006), and maternal substance abuse during pregnancy (p = .044). Prenatal care attendance (p = .023) and complications during pregnancy (p = .027) were identified as significant contributors to LBW. Substance abuse (p = .013), pregnancy complications (p = .022), and prenatal care attendance (p = .044) showed reasonable accuracy in predicting low birthweight in the ROC analysis. Conclusions Among high-risk adolescent mothers, both biological factors, such as pregnancy complications, and behavioural factors amenable to intervention, such as substance abuse and insufficient prenatal care, seem to contribute to reduced birthweight in their children, a predisposing factor for poorer health outcomes later in life. More tailored intervention programmes targeting the specific needs of this high-risk group are needed.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 96%

Pregnancy complications, substance abuse, and prenatal care predict birthweight in adolescent mothers

et al. 2021

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“…Few studies have explored reasons for use during lactation, although some have noted that many people are likely to resume their prepregnancy use after giving birth. 53,54 Our findings provide empirical support for this observation, with many participants who used cannabis ceasing use during pregnancy and resuming in lactation. Another small group of participants chose to cease or forego lactation to resume cannabis use.…”

Section: Discussionsupporting

confidence: 66%

Reasons for cannabis use during pregnancy and lactation: a qualitative study

Vanstone

Taneja

Popoola

et al. 2021

CMAJ

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annabis use by pregnant and lactating people is increasing, though it is difficult to establish the prevalence of cannabis use in pregnancy. Reported prevalence varies from 2% to 36%, depending on the methodology used to detect use, the population studied and the definition of use. [1][2][3][4][5][6][7][8][9][10][11][12] Pregnant people have reported using cannabis to manage pregnancy-related conditions (e.g., nausea, weight gain, sleep difficulty) [13][14][15][16][17][18][19] and pre-existing conditions (e.g., mental health, insomnia, chronic pain), 13,14,18 as well as to improve mood, mental, physical and spiritual well-being, 16,18 provide pleasure and manage stress. [13][14][15][16] Recent systematic reviews have not found empirical data on reasons for cannabis use during lactation. 20,21 Evidence is still emerging about clinical outcomes related to cannabis use during pregnancy and lactation, and wellcontrolled studies are lacking. [22][23][24] The available evidence is limited by reliance on self-reported data about dose, composition and timing of exposure, the changing nature of tetrahydrocannabinol levels in cannabis over time, and a lack of studies that control for known confounders such as polysubstance and tobacco use. [25][26][27][28][29][30][31] The available evidence does suggest that cannabis use during pregnancy may be associated with complications such as low birth weight, childhood neurodevelopmental outcomes and preterm birth. [22][23][24]32,33 Very few studies have analyzed the outcomes associated with cannabis exposure through breastmilk, with 1 study suggesting decreased infant motor development and another showing no effects on developmental outcomes. [34][35][36] Given the potential harms identified, and in the absence of high-quality evidence available to guide practice, most clinical guidelines recommend abstinence from cannabis during pregnancy and lactation. [37][38][39] People who perceive benefits from cannabis may wish to or may be motivated to continue using it through pregnancy and lactation, however. Counselling that explores the reasons

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“…61 In a more recent study, prenatal cannabis use was associated with a 50% increased likelihood of low birth weight, independent of confounders, although no association was found for small for gestational age, preterm birth and neonatal intensive care unit admission. 62 Furthermore, another recent population-based retrospective cohort study that included 661 617 pregnancies reported that cannabis users (n = 9427) were twice as likely to have a preterm birth compared with non-users, after adjusting for confounding variables, including tobacco use. 63 Cannabis use can also affect breastfeeding as evidence suggests that THC and CBD can accumulate in breast milk.…”

Section: Impact Of Cannabis Use In Pregnancymentioning

confidence: 99%

The ethics and management of cannabis use in pregnancy following decriminalisation and licensing for medical use: narrative review

Towobola

Nair

et al. 2021

BJPsych Bull

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Aims and method As drug policies pertaining to cannabis use become more liberalised, the prevalence of cannabis use in pregnancy could increase. However, there is limited guidance available for clinicians. This paper presents a narrative review of literature published in the past 16 years (2006–2021) to (a) address the impact of legalisation and decriminalisation on the risks, ethics and support of women who use cannabis during pregnancy and (b) develop guidance for clinicians. Results Both national and international trends suggest increased use of cannabis over the past decade, while the risks of cannabis use for recreational or medicinal purposes in pregnancy remain unmitigated. Clinical implications This review confirmed that the recommendation of cannabinoid-based products for pregnant and breast-feeding women is currently premature. More research is needed to address safety concerns. We discussed navigating ethical concerns and suggest targeted management strategies for clinicians treating pregnant women who choose to use cannabis.

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Cannabis Use During the Perinatal Period in a State With Legalized Recreational and Medical Marijuana: The Association Between Maternal Characteristics, Breastfeeding Patterns, and Neonatal Outcomes

Cited by 22 publications

References 0 publications

Pregnancy complications, substance abuse, and prenatal care predict birthweight in adolescent mothers

Pregnancy complications, substance abuse, and prenatal care predict birthweight in adolescent mothers

Reasons for cannabis use during pregnancy and lactation: a qualitative study

The ethics and management of cannabis use in pregnancy following decriminalisation and licensing for medical use: narrative review

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