Protection Versus Progress: The Challenge of Research on Cannabis Use During Pregnancy

MacDuffie, Katherine E.; Kleinhans, Natalia M.; Stout, Kaeley; Wilfond, Benjamin S.

doi:10.1542/peds.2020-0818r

Cited by 7 publications

(2 citation statements)

References 43 publications

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“…Our review strongly supports the official policy from the American College of Obstetrics and Gynecology which recommends abstaining from marijuana use while pregnant and breastfeeding due to the potential neurodevelopmental risks to the fetus/newborn [151]. Nevertheless, both CBD and marijuana are often used (self-initiated) by women to treat nausea and vomiting during pregnancy (NVP), i.e., morning sickness [152,153]. Most cases of NVP occur only during the first trimester and subside before 20 weeks of gestation.…”

Section: Discussionsupporting

confidence: 66%

The systems medicine of cannabinoids in pediatrics: the case for more pediatric studies

O’Dell¹,

Tuell²,

Shah³

et al. 2022

Front. Biosci. (Landmark Ed)

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Introduction:The legal and illicit use of cannabinoid-containing products is accelerating worldwide and is accompanied by increasing abuse problems. Due to legal issues, the USA will be entering a period of rapidly expanding recreational use of cannabinoids without the benefit of needed basic or clinical research. Most clinical cannabinoid research is focused on adults. However, the pediatric population is particularly vulnerable since the central nervous system is still undergoing developmental changes and is potentially susceptible to cannabinoid-induced alterations. Research design and methods: This review focuses on the systems medicine of cannabinoids with emphasis on the need for future studies to include pediatric populations and mother-infant dyads. Results and conclusion: Systems medicine integrates omics-derived data with traditional clinical medicine with the long-term goal of optimizing individualized patient care and providing proactive medical advice. Omics refers to large-scale data sets primarily derived from genomics, epigenomics, proteomics, and metabolomics.

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Section: Discussionsupporting

confidence: 66%

The systems medicine of cannabinoids in pediatrics: the case for more pediatric studies

O’Dell¹,

Tuell²,

Shah³

et al. 2022

Front. Biosci. (Landmark Ed)

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“…There are real and perceived risks of disclosing prenatal substance use. Prenatal cannabis use can have greater consequences for individuals from disadvantaged backgrounds due to inequities in who gets tested and reported to child protective services and law enforcement, and some individuals may avoid prenatal care due to these concerns . In California, prenatal cannabis use is not sufficient to make a child abuse or neglect report .…”

Section: Discussionmentioning

confidence: 99%

Prenatal Cannabis Use and Maternal Pregnancy Outcomes

Young-Wolff,

Adams,

Alexeeff

et al. 2024

JAMA Intern Med

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ImportanceMany studies have evaluated whether in utero cannabis exposure is associated with fetal and neonatal outcomes, yet little is known about whether prenatal cannabis use is associated with maternal health outcomes during pregnancy.ObjectiveTo evaluate whether prenatal cannabis use is associated with maternal health outcomes during pregnancy.Design, Setting, and ParticipantsThis population-based retrospective cohort study included pregnancies in Northern California from January 2011 to December 2019 that lasted 20 weeks or longer and were screened for prenatal cannabis use.ExposuresPrenatal cannabis use was defined as any self-reported use during early pregnancy or a positive toxicology test result based on universal screening at entrance to prenatal care (approximately 8-10 weeks’ gestation). Self-reported frequency of use (daily, weekly, monthly or less, never, unknown), use defined only by self-report, and use defined only by toxicology test results were examined.Main Outcomes and MeasuresElectronic health record data were used to define the following outcomes: gestational hypertension, preeclampsia, eclampsia, gestational diabetes, gestational weight gain greater and less than guidelines, placenta previa, placental abruption, placenta accreta, and severe maternal morbidity. Adjusted risk ratios (aRRs) were calculated using a modified Poisson regression.ResultsThe sample (n = 316 722 pregnancies; 250 221 unique individuals) included 84 039 (26.5%) Asian/Pacific Islander, 20 053 (6.3%) Black, 83 145 (26.3%) Hispanic, and 118 333 (37.4%) White individuals; the mean (SD) age was 30.6 (5.4) years. Overall, 20 053 (6.3%) screened positive for prenatal cannabis use; 2.9% were positive by self-report, 5.3% by toxicology testing, and 1.8% by both. The frequency of cannabis use was 1930 (0.6%) daily, 2345 (0.7%) weekly, 4892 (1.5%) monthly or less, and 10 886 (3.4%) unknown. Prenatal cannabis use was associated with greater risk of gestational hypertension (aRR, 1.17; 95% CI, 1.13-1.21), preeclampsia (aRR, 1.08; 95% CI, 1.01-1.15), weight gain less than (aRR, 1.05; 95% CI, 1.01-1.08) and greater than (aRR, 1.09; 95% CI, 1.08-1.10) guidelines, and placental abruption (aRR, 1.19; 95% CI, 1.05-1.36). The pattern of results was similar when defining prenatal cannabis use only by self-report or only by toxicology testing, and associations between the frequency of prenatal cannabis use and outcomes varied with outcome.Conclusions and RelevanceThe results of this cohort study suggest that prenatal cannabis use was associated with several adverse maternal health outcomes during pregnancy. Continued research is needed to understand whether characteristics of prenatal cannabis use (eg, dose, mode, and timing) moderate these associations.

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