Perinatal Marijuana Use and the Developing Child

Abstract

Increasing public attention has recently been paid to the opioid epidemic and attendant effects on prenatally exposed infants and children. 1 Current literature has emerged proposing marijuana as a safe alternative to opioids in addressing pain 2 and cannabis legalization as a way to decrease opioid fatalities. 3 As a result, perceptions of cannabis safety have increased, and the prevalence of marijuana use among pregnant women has expanded; past-month cannabis use among pregnant US women increased from 2.4% to 3.9% between 2002 and 2014. 4 Further, cannabis potency has been substantially increasing over the past 4 decades in the United States, and will likely continue to do so as extraction procedures of active components improve.Although cannabis does have known medical utility for some conditions, its associated acute and longterm psychoactive effects on brain function are also known. Expanding use of cannabis among pregnant and lactating women (as likely will occur with legalization) may lead to increased risk from fetal and child exposures if the teratogenic potential of cannabis remains underappreciated.Delta-9-tetrahydrocannabinol (THC), the major psychoactive component of marijuana (1 of more than 500 components, 104 of which are cannabinoids), crosses the placental barrier readily. Accumulating evidence in animals and humans indicates that prenatal

Recreational Cannabis Legalization in the US and Maternal Use during the Preconception, Prenatal, and Postpartum Periods

“…Increase use of cannabis during pregnancy and postpartum may have implications for maternal and child health, but these outcomes are not yet well understood. Studies examining the relationship between perinatal cannabis use and adverse child health outcomes show mixed findings [1,[19][20][21][22][23][24][25][26][27][28]. Emerging research indicates the female reproductive system is influenced by the endocannabinoid system, meaning chronic exposure to cannabis could lead to disruption of menstrual cycles, depression of ovarian follicular maturation, and reductions in key hormones needed for ovulation [29].…”

Cannabis “in utero”: the fetus as a compulsive consumer

“…It is urgent to spread the potential repercussions of cannabis use on maternal and fetal health during pregnancy [44]. There is mounting evidence to suggest that perinatal cannabis exposure can have negative effects and the combination of increasing trends in consume, potency, and acess poses an important public health and clinical practice challenge [33,59]. Whereas the general population increasingly views cannabis as safe, measures to disseminate reliable information on the harm caused by cannabis use during pregnancy are urgently needed, preventing thousands of children from being exposed to the harmful effects that begin during the intrauterine period [18,53,61].…”

Alcohol, smoking, and other substance use in the perinatal period

“…Tetrahydrocannabinol, the main psychoactive component of cannabis, readily crosses the placental barrier 39. Synthetic cannabinoid receptor agonists (SCRAs) such as “spice” are also potent stimulators of the endocannabinoid system, and their safety during pregnancy is unknown.…”