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Cannabis and Pregnancy

In the past years, a growing number of nations worldwide have legalized marijuana consumption, making it accessible to the general public. After the emergence of societal and medical acceptance towards marijuana, conceivably, its usage among pregnant women has also increased.

Studies have been conducted over several years to construe the safety and harm of cannabis during pregnancy. Currently, the usage of marijuana during pregnancy and postpartum is known to be increasing rapidly. Yet, there are gaps in statistical data collection due to the broadness of the subject matter itself and limitations in research; verifying that it still requires extensive documentation. 

The potency of cannabis depends on several factors, like the region of its origination, method of cultivation, its size, the THC content, and its storage mechanism. These factors collectively are tough to scrutinize, and proper compilation into single literature that could pin down a safe consumption amount is challenging. 

Globally, from the 1970s to the 2000s alone, THC potency has increased by six to seven times the previous amount. Thus, the studies from the 1970s to the 80s may seemingly be misleading on the harmful effects of current cannabis use. Present-day or future studies must keep up with the progression of THC potency keeping in mind the different ways it reacts with different demographics. 

Among the confirmed and reported maternal cannabis use, most of these cases are recorded in the 1st trimester of pregnancy, substantially for recreational purposes rather than medical. Since the 1st trimester is the most delicate and crucial time for normal fetal development, the fetal brain is susceptible to maximum damage. THC — the psychoactive compound found in cannabis that induces a high sensation — could reach the fetal brain through the bloodstream. It could then negatively impact the developing body structure, brain development, and organ system of the fetus.

A precise mechanism that affects the neurochemical system in the fetus due to maternal cannabis use is not well studied. It is common knowledge that cannabinoid receptors are present in the placenta. The placenta is a highly lipophilic barrier organ attached to a fetus through the uterus wall. Cannabinoid receptors first appear in the fetal brain during the 1st trimester, increasing its density throughout the 3rd trimester. 1/3rd of the THC in maternal plasma readily bypasses the placental barrier — which is feeble when it comes to blockading chemicals — and directly affects the fetus during gestation. 

Offsprings exposed to marijuana via maternal use during pregnancy are likely to sustain its long-term effects later in childhood. These include difficulty in visual-perceptual tasks, impaired visual memory, poor attention spans, troubles with language acquisition, reading, spelling, and problem-solving skills. It was also a crucial finding that these effects may not appear until adolescence. 

Maternal cannabis use is evident to cause palpable changes in neonate brain chemistry, studies on research in animals, as well as humans, have shown. THC stimulates and disrupts the natural procedure of the endocannabinoid system. This system is a complex nervous signaling system responsible for physiological, cognitive, and emotional functions like memory, sleep, addiction, and learning. Further studies show that the exposure of cannabis to fetuses during pregnancy disrupts the development of neurotransmitters such as the dopamine function system. Hence, an infant of cannabis users may be at a higher risk of mental disorders later in life including, Attention Deficit Hyperactivity Disorder (ADHD), anxiety, and depression.

Physically, low birth weight, preterm birth, stillborn, baby being little for gestational age, small birth length, and neonatal ICU (intensive care unit) admission are some of the detrimental effects of antenatal (before birth) cannabis consumption. While few studies disagree with these findings, there is a little but statistically noticeable decrement in birth weight. Babies of women who consumed cannabis promptly before and during pregnancy are half as more inclined to be born approximately 200g lighter, have a remarkably shorter birth length and have smaller head circumferences.

The literature analyzing the exposure of cannabis to a newborn through breastfeeding also includes concerning pointers and findings as well. When examining the movement of THC in a human body and breast milk, THC was observed to be crossing the blood-brain barrier that is supposed to prevent the circulation of toxins or pathogens to a fetus. This phenomenon affects the developing fetal brain and raises a significant concern in neonatal health.

THC in breast milk is inconsistently present based on the ingestion amount and frequency during breastfeeding. Unlike several other drugs and medications that are excreted into breast milk but do not stay concentrated there, THC is found to be secreted into and remains in the breast milk in itself. Studies have traced remnants of THC in the stool of an infant, establishing that these infants absorbed and metabolized the THC present in the breast milk.

Aside from the recreational use of marijuana, a minority of women use cannabis as an alternative to treat symptoms such as morning sickness and nausea. Since morning sickness primarily occurs during the first trimester, it is also precisely not a good time for cannabis consumption as the fetal brain is fragile in that period. 

There are no laws against the use of cannabis during pregnancy in the nations that have legalized it, making it a serious health concern. Approved use of marijuana is likely to encourage complacency regarding the fetal, neonatal, and childhood risks of maternal marijuana use. It is dire for professionals to instruct pregnant women about the known long-term effects of cannabis consumption and also shed light on what is unknown presently. 

Curtailing the stigma against admitted maternal consumption of marijuana would help patients in confiding to the professionals, facilitating them to get a proper screening. Additional information about the possible risks while also suggesting other therapeutic alternatives to marijuana in treating their symptoms would cultivate a healthier alliance between healthcare providers and the patients. 

Marijuana use in pregnancy is considered a preventable hazard. A speedy detection through screening and alerting both the parents and their families is an effective way to minimize its possible harm. Counseling the women who admit to the occasional or even rare use of marijuana is an efficient way to avoid further use as much as possible during lactation. Women who struggle with marijuana usage need urgent and utmost attention in order to control or preferably discontinue their consumption. This can aid in giving their offspring a chance at unobstructed physiological and neurological development. 

Current data on marijuana usage of pregnant women based on the amount, their frequency of consumption, and the form of consumption are limited. Conventional examination of the relationship between cannabis usage during pregnancy and negative health issues caused by it, for both pregnant women and their offspring, must have consistent and standardized data. Proper assessment of marijuana usage in pregnant women during their pregnancy-related appointments, along with a meticulous record of infant’s birth outcome data, would be beneficial. 

Since there is insufficient data, the issue is still premature and conflicting, with no single unwitting disclosure about its risks or benefits. The absence of such plausible data discourages consumption during pregnancy with its possible threats in mind. 

 

Three puffs a day of cannabis helps people with chronic nerve pain, it makes them feel less pain and sleep better. About 10% to 15% of patients attending chronic pain clinics use cannabis as part of their pain control strategy

Mark Ware, M

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