Many people think that cannabinoids, like marijuana, are harmless during pregnancy, but research suggests otherwise.
· “Cannabinoid” is a term to describe a group of 66 ingredients found in the flowering cannabis plant.
· Each of these 66 chemicals affects brain receptors differently.
· A main ingredient in marijuana is THC (tetrahydrocannabinol).
· Concentrations of THC in marijuana have increased by 121 percent since 1983.
· THC is stored in fat and can linger in a mother’s body for months after her last use.
· No one knows whether the fetal exposure to THC continues during the time THC remains in the mother’s body.
Modern marijuana use is not limited to smoking. There are other forms available on the market, such as oils rubbed on the skin or edible forms that can be swallowed. Research on these oils and edibles is limited and the lack of regulation of these products makes their use concerning in pregnant women.
· Cannabinoids appear to have an undesirable effect in pregnancy.
· Edibles have a delayed response and can take up to two hours to create an effect after eating.
o Accidental overdosing can occur when a person consumes multiple servings close together leading to higher levels of intoxication.
· There is no regulation on cannabinoid oils and levels of THC in these products vary, according to the processes used by that particular manufacturer.
THC can cross the placenta to reach the fetus and can harm brain development and birth weight. THC can also cross into breast milk and create issues after childbirth.
· Brain development after maternal marijuana use can change critical circuits and receptors affecting emotional regulation, reward, motor functions and cognition.
· Moms who use marijuana and breastfeed their babies expose their infants to high levels THC.
o Because THC is stored in fat cells, some sources report 7x higher levels of THC in breast milk than in the mother’s bloodstream.
· Results of maternal THC use are not always immediate:
o 6-year-olds born to mothers who had smoked one joint or more a day in early pregnancy had decreased listening and reading ability.
o At age 10, children exposed to THC during their mother’s pregnancy were more impulsive than other children were. They were also less able to focus their attention.
o Children of mothers who used marijuana heavily in early pregnancy had lower reading, math and spelling scores at age 14 than their peers.
Depression, anxiety, stress, pain, nausea and vomiting were the most common reasons women reported using marijuana in pregnancy.
· Marijuana use during pregnancy can cause a condition called “Cannabinoid Hyperemesis Syndrome”, or frequent vomiting.
“Women are thinking of this as medical marijuana in that they are treating some condition,” said Elizabeth Nash, a policy analyst at the Guttmacher Institute who researches substance abuse in pregnancy. “If you’re going to consider it like medicine,” she said, “then treat it like medicine and talk to your doctor about it.”
Centers for Disease Control, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists, all advise against prenatal cannabis use because of its links to cognitive impairment and academic underachievement. The American College of Obstetricians and Gynecologists advises clinicians to ask pregnant women about marijuana use and to urge them to quit.
As always, reach out to Labor of Love for support accessing community resources before, during or after your delivery. Our goal is to provide our families with the best resources our community has to offer.
LovelaceLaborOfLove@lovelace.com / 505.727.7677
Submitted by Kym Halliday Clear, RN / Manager Outpatient Programs, Lovelace Women’s Hospital
Brown QL, Sarvet AL, Shmulewitz D, Martins SS, Wall MM, Hasin DS. Trends in Marijuana Use Among Pregnant and Nonpregnant Reproductive-Aged Women, 2002-2014. JAMA. 2017;317(2):207-209. doi:10.1001/jama.2016.17383
Lidush Goldschmidt, Nancy L. Day, Gale A. Richardson. Effects of prenatal marijuana exposure on child behavior problems at age 10. Neurotoxicolgy and Tetralolgy. 2000;22(3): 325-336. doi:10.1016/S0892-0362(00)00066-0
Marijuana use during pregnancy and lactation. Committee Opinion No. 637. American College of Obstetricians and Gynecologists. Obstet Gynecol 2015;126:234–8.
Marylou Behnke, Vincent C. Smith, Prenatal Substance Abuse: Short- and Long-term Effects on the Exposed Fetus. Pediatrics. March 2013, VOLUME 131 / ISSUE 3. © 2013 by the American Academy of Pediatrics