Recurrent Nausea and Vomiting in a Pregnant Woman with Chronic Marijuana Use

Kim, Hyunyoung G.; Moon, Jeremiah H; Dixon, Heather; Tullar, Paul

doi:10.1155/2018/9746062

Cited by 14 publications

(25 citation statements)

References 22 publications

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“…The copyright holder for this preprint this version posted September 7, 2020. ; https://doi.org/10.1101/2020.07.24.220103 doi: bioRxiv preprint provoke recurrent nausea and vomiting rather than combat it (Kim et al, 2018). Cannabis consumption during pregnancy is especially prevalent during the first and second trimesters; in the U.S. 8% of pregnant women in the first trimester report consuming cannabis in the past 30 days (Volkow et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Combined vapor exposure to THC and alcohol in pregnant rats: Maternal outcomes and pharmacokinetic effects

Breit

Rodriguez

Lei

et al. 2020

Neurotoxicology and Teratology

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Cannabis is the most frequently used illicit drug among pregnant women, yet the potential consequences of prenatal cannabis exposure on development are not well understood. Electronic cigarettes have become an increasingly popular route of administration among pregnant women, in part to user's perception that e-cigarettes are a safer route for consuming cannabis products. Importantly, half of pregnant women who consume cannabis also report consuming alcohol, but research investigating co-consumption of these drugs is limited, particularly with current routes of administration.The purpose of this study was to establish a co-exposure vapor inhalation model of alcohol and THC in pregnant rats, to ultimately determine the effects on fetal development. Pregnant Sprague-Dawley rats were exposed to moderate doses of THC via e-cigarettes, alcohol, the combination, or vehicle daily from gestational days 5-20. Importantly, pharmacokinetic interactions of alcohol and THC were observed during pregnancy. Combined exposure consistently increased blood alcohol concentrations, indicating that THC alters alcohol metabolism. In addition, THC levels also increased over the course of pregnancy and THC metabolism was altered by alcohol. Alcohol, but not THC, exposure during pregnancy reduced maternal weight gain, despite no group differences in food intake. Neither prenatal alcohol nor THC exposure altered gestational length, litter size, sex ratio or birth weight. However, prenatal alcohol exposure delayed eye opening, and prenatal THC exposure decreased body weights during adolescence among offspring. These individual and synergistic effects suggest that this novel co-exposure vapor inhalation paradigm can effectively be used to expose pregnant dams, exerting some effects on fetal development, while avoiding nutritional confounds, birth complications, or changes in litter size. With this model, we have demonstrated that combining THC and alcohol alters drug metabolism, which could have important consequences on prenatal development.

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Section: Introductionmentioning

confidence: 99%

Combined vapor exposure to THC and alcohol in pregnant rats: Maternal outcomes and pharmacokinetic effects

Breit

Rodriguez

Lei

et al. 2020

Neurotoxicology and Teratology

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show abstract

“…Unfortunately, young people increasingly view all cannabis use as safe (Brown et al, 2017;Johnston et al, 2015), and both pregnant and non-pregnant women perceive cannabis as posing a minimal risk (Jarlenski et al, 2017). In fact, many pregnant women purposefully take cannabis products for pregnancy-related illness such as nausea (Dickson et al, 2018), even though cannabis may actually provoke recurrent nausea and vomiting rather than combat it (Kim et al, 2018). Cannabis consumption during pregnancy is especially prevalent during the first and second trimesters; in the U.S. 8% of pregnant women in the first trimester report consuming cannabis in the past 30 days (Volkow et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Combined Vapor Exposure to THC and Alcohol in Pregnant Rats: Maternal Outcomes and Pharmacokinetic Effects

Breit

Rodriguez

Lei

et al. 2020

Preprint

View full text Add to dashboard Cite

Cannabis is the most frequently used illicit drug among pregnant women, yet the potential consequences of prenatal cannabis exposure on development are not well understood. Electronic cigarettes have become an increasingly popular route of administration among pregnant women, in part to user’s perception that e-cigarettes are a safer route for consuming cannabis products. Importantly, half of pregnant women who consume cannabis also report consuming alcohol, but research investigating co-consumption of these drugs is limited, particularly with current routes of administration. The purpose of this study was to establish a co-exposure vapor inhalation model of alcohol and THC in pregnant rats, to ultimately determine the effects on fetal development. Pregnant Sprague-Dawley rats were exposed to moderate doses of THC via e-cigarettes, alcohol, the combination, or vehicle daily from gestational days 5-20. Importantly, pharmacokinetic interactions of alcohol and THC were observed during pregnancy. Combined exposure consistently increased blood alcohol concentrations, indicating that THC alters alcohol metabolism. In addition, THC levels also increased over the course of pregnancy and THC metabolism was altered by alcohol. Physically, alcohol, but not THC, exposure during pregnancy reduced maternal weight gain, an effect not due to differences in food intake, which did not vary group. Neither prenatal alcohol nor THC exposure altered gestational length, litter size, sex ratio or birth weight. However, prenatal alcohol exposure delayed eye opening, and prenatal THC exposure decreased body weights during adolescence among offspring. These individual and synergistic effects suggest that this novel co-exposure vapor inhalation paradigm effectively induces intoxication in pregnant dams and exerts some effects on fetal development, while avoiding nutritional confounds, birth complications, or changes in litter size. With this model, we have demonstrated that combining THC and alcohol alters drug metabolism, which could have important consequences on prenatal development.The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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“…We employed the search terms 'Cannabinoid' 'Hyperemesis' and 'Pregnancy' in PubMed and Google scholar. We identi ed ve clinical cases (8)(9)(10)(11)(12) and extracted their characteristics (detailed in the appendix tables).…”

Section: Discussionmentioning

confidence: 99%

Cannabinoid Hyperemesis Syndrome in the pregnant patient: clinical case and literature review

Flament

Scius

Thonon

2020

Preprint

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Background Cannabis use is on the rise. Several cases of cannabinoid hyperemesis syndrome, secondary to chronic cannabis intoxication, have been described worldwide, but few cases have described this entity in pregnant women. Case presentation We describe a 29-year-old pregnant patient that had consumed cannabis and experienced uncontrolled vomiting. The use of hot baths, the rapid improvement in symptoms, and results of complementary examinations suggested a diagnosis of cannabinoid hyperemesis syndrome. The patient could return home and she continued her pregnancy and childbirth without peculiarities. Conclusion Cannabinoid hyperemesis syndrome should be considered in the differential diagnosis of vomiting in pregnancy. Consumption of cannabis must be systematically included in the anamnesis. However, it seems to be somewhat unacceptable socially or medically. Consumption must be stopped to manage symptoms.

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Recurrent Nausea and Vomiting in a Pregnant Woman with Chronic Marijuana Use

Cited by 14 publications

References 22 publications

Combined vapor exposure to THC and alcohol in pregnant rats: Maternal outcomes and pharmacokinetic effects

Combined vapor exposure to THC and alcohol in pregnant rats: Maternal outcomes and pharmacokinetic effects

Combined Vapor Exposure to THC and Alcohol in Pregnant Rats: Maternal Outcomes and Pharmacokinetic Effects

Cannabinoid Hyperemesis Syndrome in the pregnant patient: clinical case and literature review

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