Pregnant Women's Current and Intended Cannabis Use in Relation to Their Views Toward Legalization and Knowledge of Potential Harm

Mark, Katrina; Gryczynski, Jan; Axenfeld, Ellen; Schwartz, Robert P.; Terplan, Mishka

doi:10.1097/adm.0000000000000299

Cited by 123 publications

(154 citation statements)

References 26 publications

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“…In a nationally representative sample of pregnant women, the proportion of individuals perceiving no risk of harm from regular cannabis use increased substantially among both cannabis users (25.8% to 65.4%) and nonusers (3.5% to 16.5%) between 2005 and 2015 . In another study, 10% of pregnant women indicated that they would use cannabis more during pregnancy if it were legalised . Of concern, this practice may also be endorsed by cannabis retailers.…”

Section: Discussionmentioning

confidence: 97%

“…This observation aligns with the hypothesis that women may discontinue their cannabis use once they become aware of the pregnancy or that they may turn to cannabis to alleviate nausea and vomiting during the first trimester. Accordingly, a small survey of pregnant women revealed that almost all women who continued to use cannabis after pregnancy diagnosis did so to self‐treat symptoms of morning sickness . Furthermore, in a sample of over 200 000 pregnant women, those with severe (aOR = 3.80, 95% CI 3.19–4.52) or mild (aOR = 2.37, 95% CI 2.17–2.59) nausea or vomiting of pregnancy had increased odds of cannabis use in the first trimester relative to women without these symptoms .…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and outcomes of prenatal recreational cannabis use in high‐income countries: a scoping review

Singh

Filion

Abenhaim

et al. 2019

BJOG

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Background With expanding recreational cannabis legalisation, pregnant women and their offspring are at risk of potentially harmful consequences. Objectives To assess the prevalence of recreational cannabis use among pregnant women, health outcomes associated with prenatal recreational cannabis use, and the potential impact of recreational cannabis legalisation on this population. Search strategy Five databases and the grey literature were systematically searched (2000–2019). Selection criteria Human studies published in English or French reporting on the prevalence of prenatal recreational cannabis use in high‐income countries. Data collection and analysis Data on study characteristics, prenatal substance use, and health outcomes were extracted and qualitatively synthesised. Main results Forty‐one publications met our inclusion criteria. The overall prevalence of prenatal cannabis use varied substantially (min–max: 0.24–22.6%), with the greatest use in the first trimester. In the three studies with temporal data available, rates of prenatal cannabis use increased across years. Only 7/41 and 5/41 studies provided information on gestational age of exposure and frequency of use, respectively. The concomitant use of alcohol, illicit drugs, and tobacco was higher among cannabis users than nonusers. Prenatal cannabis use was associated with select neonatal, but not maternal, health outcomes. There were insufficient data to compare prenatal cannabis use between the pre‐ and post‐legalisation periods. Conclusion Cannabis use among pregnant women is prevalent and may be associated with adverse neonatal outcomes. Future studies should assess the gestational age and frequency of cannabis exposure, and usage patterns prior to and following legalisation. Tweetable abstract Women who consume cannabis during pregnancy could risk predisposing their newborns to poor birth outcomes.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Prevalence and outcomes of prenatal recreational cannabis use in high‐income countries: a scoping review

Singh

Filion

Abenhaim

et al. 2019

BJOG

View full text Add to dashboard Cite

show abstract

“…For example, a survey of women in Vancouver, Canada found that up to 77% of medicinal cannabis use during pregnancy was related to nausea; over 50% of respondents also reported cannabis use to treat a lack of appetite, general pain, insomnia, anxiety, depression and fatigue (Westfall et al, 2009). Despite knowledge of potential fetal health risks, cannabis use in pregnant women is becoming more commonplace and the need for clear messaging on the safety of use during pregnancy is urgently needed (Mark et al, 2017). …”

Section: Introductionmentioning

confidence: 99%

Cannabis use during pregnancy: Pharmacokinetics and effects on child development

Grant

Petroff

Isoherranen

et al. 2018

Pharmacology & Therapeutics

188

159

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The broad-based legalization of cannabis use has created a strong need to understand its impact on human health and behavior. The risks that may be associated with cannabis use, particularly for sensitive subgroups such as pregnant women, are difficult to define because of a paucity of dose-response data and the recent increase in cannabis potency. Although there is a large body of evidence detailing the mode of action of Δ9‐tetrahydrocannabinol (THC) in adults, little work has focused on understanding how cannabis use during pregnancy may impact the development of the fetal nervous system and whether additional plant-derived cannabinoids might participate. This manuscript presents an overview of the historical and contemporary literature focused on the mode of action of THC in the developing brain, comparative pharmacokinetics in both pregnant and nonpregnant model systems and neurodevelopmental outcomes in exposed offspring. Despite growing public health significance, pharmacokinetic studies of THC have focused on nonpregnant adult subjects and there are few published reports on disposition parameters during pregnancy. Data from preclinical species show that THC readily crosses the placenta although fetal exposures appear lower than maternal exposures. The neurodevelopmental data in human and preclinical species suggest that prenatal exposure to THC may lead to subtle, persistent changes in targeted aspects of higher-level cognition and psychological well-being. There is an urgent need for well-controlled studies in humans and preclinical models on THC as a developmental neurotoxicant. Until more information is available, pregnant women should not assume that using cannabis during pregnancy is safe.

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“…It is also the most commonly used illicit drug used among pregnant women 2 in the United States, with prevalence rates ranging from 3-4% 3 and higher rates among pregnant adolescents 4 . Given the recent legalization of cannabis in many states, the perception that cannabis is safe to consume during pregnancy 5 , and the reported intention of use among pregnant women despite knowledge of potential risks 6 , the availability and use of cannabis among pregnant women is likely to increase. Importantly, maternal ingestion of Δ9-tetrahydrocannabinol (THC), the primary psychoactive constituent in cannabis, can have direct effects on fetal development, as THC and its metabolites can freely pass across the placenta 7 .…”

Section: Introductionmentioning

confidence: 99%

Altered Motor Development Following Late Gestational Alcohol and Cannabinoid Exposure in Rats

Breit

Zamudio

Thomas

2019

Preprint

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Cannabis is the most commonly used illicit drug among pregnant women, and rates are likely to increase given recent legalization. In addition, half of pregnant women who report consuming cannabis also report drinking alcohol. However, little is known about the consequences of prenatal cannabis alone or combination with alcohol, particularly with cannabis products that are continually increasing in potency of the primary psychoactive constituent in cannabis, Δ9-tetrahydrocannabinol (THC). The current study investigated the effects of early exposure to cannabinoids during the brain growth spurt on early physical and motor development alone (Experiment 1) or in combination with alcohol (Experiment 2). In Experiment 1, Sprague-Dawley rat pups were exposed to a cannabinoid receptor agonist (CP-55,940 [CP]; 0.1, 0.25, 0.4 mg/kg/day), the drug vehicle, or a saline control from postnatal days (PD) 4-9. In Experiment 2, rat pups were exposed to CP (0.4 mg/kg/day) or the vehicle, and were additionally intubated with alcohol (11.9% v/v; 5.25 g/kg/day) or received a sham intubation. Subjects in both experiments were tested on a motor development task (PD 12-20) and a motor coordination task during adolescence (PD 30-32). Both developmental cannabinoid and alcohol exposure separately decreased body growth throughout development, and combined exposure exacerbated these effects, although only alcohol exposure induced long-term body weight reductions. Developmental cannabinoid exposure advanced early motor development, whereas alcohol exposure delayed development, and subjects given combined exposure did not differ from controls on some measures. Alcohol exposure impaired motor coordination later in life. In contrast, cannabinoid exposure, by itself did not significantly affect long-term motor coordination, but did exacerbate alcohol-related impairments in motor coordination among females. These results suggest that cannabinoid exposure may not only alter development by itself, but may exacerbate alcohol's teratogenic effects in specific 3 behavioral domains. These findings have important implications not only for individuals affected by prenatal exposure, but also for establishing public policy for women regarding cannabis use during pregnancy.

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Pregnant Women's Current and Intended Cannabis Use in Relation to Their Views Toward Legalization and Knowledge of Potential Harm

Cited by 123 publications

References 26 publications

Prevalence and outcomes of prenatal recreational cannabis use in high‐income countries: a scoping review

Prevalence and outcomes of prenatal recreational cannabis use in high‐income countries: a scoping review

Cannabis use during pregnancy: Pharmacokinetics and effects on child development

Altered Motor Development Following Late Gestational Alcohol and Cannabinoid Exposure in Rats

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