Pregnancy, Breast-feeding, and Marijuana

Abstract

Marijuana is a commonly used drug. At present, it remains an illegal substance in most areas of the United States. Recent controversy regarding the perceived harms of this drug has resulted in debate in both legal and medical circles. This review examines evidence regarding the effects of marijuana exposure during pregnancy and breast-feeding. We examined studies pertaining to fetal growth, pregnancy outcomes, neonatal findings, and continued development of fetuses and neonates exposed to marijuana through adolescence. In addition, the legal implications for women using marijuana in pregnancy are discussed with recommendations for the care of these patients. The current evidence suggests subtle effects of heavy marijuana use on developmental outcomes of children. However, these effects are not sufficient to warrant concerns above those associated with tobacco use. Marijuana is the most commonly used illicit substance in the United States. It is predominantly used for its pleasurable physical and psychotropic effects. With the recent changes to legislature in Colorado and Washington State making the recreational use of marijuana legal, marijuana has gained national attention. This raises the question: If it is legal for a woman to consume marijuana, what is the safety of this activity in pregnancy and breast-feeding? Moreover, do the harms of marijuana use on the fetus or infant justify the mandatory reporting laws in some states?

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

“…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).…”

Suppression of STAT3 Signaling by Δ9-Tetrahydrocannabinol (THC) Induces Trophoblast Dysfunction

“…Although the placenta acts as a barrier to protect the fetus from toxic chemicals present in the maternal bloodstream [10], THC readily crosses the placenta and enters into the fetal bloodstream [11]. Consequently, THC may act to alter the normal function of placental trophoblasts, fetal development and influence the growth of newborns as it is also detected in breast milk [12]. Not surprisingly, marijuana use before and/or during pregnancy has been implicated in producing negative pregnancy outcomes such as abortion [13], preterm birth [14] and fetal growth restriction [15, 16].…”

It's Not Your Mother's Marijuana

“…24 These laws have been found to hinder the physician-patient relationship, decrease compliance with prenatal care, and increase the risk of perinatal mortality. 17,18,25 Due to fears of incarceration or the loss of one’s children, pregnant women may not be willing to disclose their use. For this reason, it is imperative to preserve the physician-patient relationship which will allow women to feel safer discussing drug use with their provider.…”

“…More detailed information is available in recent reviews by Rowe et al 56 and Hill and Reed. 25 At the present time, the American Academy of Pediatrics recommends that women who are using street drugs, including marijuana, not breastfeed their infants. 57 …”