Ruminations: Cannabis? Best to Avoid During Pregnancy

"Unfortunately, it would seem that health-care professionals are not good sources of information for pregnant women. One study found that only half provided counselling when informed of marijuana use during pregnancy and this often focused on the legal rather than the medical consequences. In fact, women reported that it was difficult to find reliable information on cannabis use during pregnancy and often relied on anecdotal advice from friends or family."
"Clearly, how we as a society view cannabis has changed drastically in the past decade and has led to its general acceptance and legalization. But we should not forget that there are potential risks to its use, and regardless or whether you support its legalization or not, probably best to avoid it while pregnant."
Dr. Christopher Labos, McGill Office for Science and Society, Montreal

Obstetrician-gynecologists in Canada are seeing an increasing number of pregnant women who think that using marijuana through their pregnancy is fine, that there are no risks associated with doing so. It has also been agreed that cannabis represents the most commonly used drug during pregnancy. Women appear to be cognizant that to protect their growing foetus it is best to avoid alcohol and smoking and the use of those two potential health risks are steadily reducing. Daily use of cannabis on the other hand during the first trimester of pregnancy appears to be on the increase.

That is of particular concern to the health community given the reality that the drug has become more potent than it once was. Cannabis use does come with risks, aside from risks associated with its use during pregnancy. Heavy use of marijuana by teens is fraught with a particular danger to the maturing brain. Its potential effect on mental health in the young represents yet another concern, which is why the medical community recommends it not be used until maturity, around 22 years of age. CBD has properties that may also be considered to be problematical for health.

All this aside from its recognized use for health benefits for people suffering from some chronic conditions finding relief with cannabis use. For pregnant women the general consensus among the medical community is that women be advised to avoid its use. The American Academy of Obstetricians and Gynecologists has warned against cannabis use in pregnancy. It was clearly found in a matched cohort analysis using Ontario health data that cannabis use is associated with an increase in preterm births (10.2 percent as opposed to 7.2 percent).

Babies whose mothers use cannabis while pregnant are likelier to be transferred to the neonatal ICU because they're born smaller. In addition to which an increase in stillbirths has been noted. However, not all studies support these conclusions. A different 2016 meta-analysis found no increased risk of preterm births. When expectant mothers smoke tobacco it is difficult to separate that issue from the harms seen in smoking marijuana. The debate becomes how much of an increased risk is attributable to smoking, as opposed to marijuana use.

Long-term effects that cannabis can have on the developing brain of the foetus represents yet another concern. If it is seen -- and it is -- to affect the brain development of teens, it makes sense that the drug would cross the placenta to affect the brain of the developing foetus. There may be some confusion resulting in society linked to the issue of legalization leading to the increasing popularity of cannabis use. People tend to think that something that is legal is also safe, thus making it more socially acceptable.

Data from the U.S. National Survey on Drug Use and Health database reveal the proportion of women believing marijuana use to hold no risks during pregnancy rose from 4.6 percent to 19 percent between the years 2005 and 2015. Women appear to rely sometimes on advice they solicit from cannabis dispensaries. One study indicated that 70 percent of Colorado dispensaries recommend marijuana as a morning sickness treatment, an actual misrepresentation.

Vox

Risks to a child’s brain development
Use of cannabis during pregnancy may affect a child’s brain development, behaviour and mental health into adolescence and early adulthood. The effects may be permanent. If a mother uses cannabis daily, some of the risks for the child may be:
Age 0 – 3 years:

Difficulty calming down

Exaggerated startles

Sleep problems

Age 3 – 6 years:

Poorer memory

More impulsive

Less attentive

Less able to understand and follow instructions

Age 6 – 10 years:

More hyperactive and impulsive

More difficulty learning

Symptoms of depression and anxiety

More difficulty making decisions

Less attentive

Age 14 – 18 years:

Poorer school performance

Delinquency problems

May try and/or use cannabis earlier

Continue to be hyperactive, impulsive and less attentive

Government of Canada Website