While most people know that an increasing number of states have legalized cannabis for recreational and medicinal use, one trend that many may not realize is that the number of pregnant women who smoke marijuana is increasing around the United States.
Whether the two trends are correlated remains to be seen. However, it should be noted that if you are pregnant and smoke cannabis, your baby can experience the negative effects of marijuana.
What are the implications of this trend? What does research reveal about the use of cannabis during pregnancy and its effects on mother and child?
Cannabis and Pregnancy Facts
One study published last year in JAMA tracked pregnant women in California from 2009 to 2016. It was a big research cohort encompassing data from nearly 280,000 pregnant women. During the study, California legalized medical marijuana (in 1996). The research found that at the beginning of the study, 4 percent of the women used cannabis during pregnancy. By the end of the study, that number had increased to 7 percent. In 2016, marijuana became legal for recreational use in California. No studies yet exist to see how the law change affected cannabis and pregnancy in California.
Ironically, another study published in JAMA Pediatrics showed that pregnant women were dropping other harmful habits, such as cigarette use and alcohol consumption, but their use of weed was actually increasing. Data from the National Survey of Drug Use and Health studied a representative sample of 13,000 pregnant women that showed cannabis consumption went from just over 2 percent to more than 5 percent.
There have been extensive public health campaigns aimed at reducing smoking and drinking during pregnancy. These campaigns appear to have been effective at making parents aware of the developmental risks associated with consuming these products during pregnancy. As of December 2018, there has not been a federal response to cannabis and pregnancy.
While cannabis has a reputation as a safer, plant-based natural drug, the American Academy of Pediatricians (AAP) expressed concern that cannabis is harmful to the fetus. Their statement in part read:
“The fact that marijuana is legal in many states may give the impression the drug is harmless during pregnancy, especially with stories swirling on social media about using it for nausea with morning sickness…But in fact, this is still a big question. We do not have good safety data on prenatal exposure to marijuana. Based on the limited data that does exist, as pediatricians, we believe there is cause to be concerned about how the drug will impact the long-term development of children.”
Cannabis and Pregnancy – What Does the Data Suggest?
In September 2018, Pediatrics stated:
“It is unclear why pregnant women are choosing to use marijuana during their pregnancy, because there are few data available on the benefits of marijuana use during pregnancy. “
Part of the reason why data does not exist on cannabis and pregnancy is that marijuana has been an illegal substance, making it harder to conduct research studies. Quartz says much of the data available is self-reported in kind of an “honor system” for expecting moms. Ethically, human studies of cannabis and pregnancy have not been conducted. While a few studies exist that track medical marijuana’s impact on pregnancy and breastfeeding, it is perceived that cannabis and pregnancy will cause a potential developmental impact on the child long-term.
The increase in marijuana use during pregnancy is likely tied to studies that show a reduction in nausea stemming from morning sickness. One study said that women were 3.8 times more likely to use marijuana if they suffered from morning sickness when compared with women who were pregnant and did not have nausea.
While scientific data is notoriously slim, the AAP suggests “Marijuana is one of the most widely used substances during pregnancy in the United States.” Their summary of the current research showed:
- 4.9 percent of pregnant women ages 15 through 44 reported marijuana use during pregnancy.
- This was an increase from the prior year.
- 8.5 percent of pregnant women ages 18 through 25 reporting using cannabis in the last 30 days.
- Infant samples showed marijuana to be in the blood of the newborns whose mothers consumed cannabis.
Their research summary also showed that of the women who received counseling on the risks of using pot during pregnancy, 78 percent abstained from using the drug up to and including during delivery. The study also found that, potentially, cannabis could:
- Affect the physiologic state of the placenta during pregnancy, potentially increasing the sensitivity of the placenta to transmission of other chemicals during pregnancy
- Affect uterine blood flow and placental circulation
The AAP cited previous research showing that substances such as tobacco or alcohol cross directly through the placenta to the fetus. They also pointed out that the active psychoactive ingredient in pot, THC, easily crosses the placental membrane and that it is distributed to the brain and fat of the fetus. The study concluded:
“Given these known effects of marijuana on the placenta and placental transport, it is biologically plausible that marijuana use during pregnancy could affect both maternal and fetal outcomes.”
Other Concerns About Cannabis and Pregnancy
For obvious reasons, conducting a clinical study that exposes a fetus to marijuana is certainly a bad idea. This creates an environment where the science certainly is not as infallible as it could be. However, Science News points out prior studies with anecdotal evidence linking cannabis and pregnancy with low birth rates and anemia in the pregnant woman. Other studies do not corroborate these findings, however.
The new strains of cannabis under legalized state laws are stronger typically than what has been seen in the past. If cannabis passes to the fetus, could any chemicals used on the plant also cross over? What about fertilizers or weed killers? Toxins from pesticides certainly pose a hazard to people, let alone a vulnerable fetus. Too, when cannabis is burned, carbon monoxide is produced and this can pass through the placental membrane to the fetus.
While the data simply does not exist in the volume needed, it may be necessary to exercise caution when mixing cannabis and pregnancy just to be safe.
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