Marijuana (also known as cannibis, weed, pot, dope or grass) is used in many countries including Anguilla. Recently there has been much debate about legalizing marijuana for medicinal or recreational purposes. In Anguilla, Cannabis sativa (marijuana) is still an illicit drug, but as more countries opt for legalization, there is concern that this might lead to increased marijuana use by pregnant women.
How does marijuana affect a pregnancy?
The active chemical in cannabis is THC (delta-9 tetrahydrocannabinol) which can pass from the pregnant woman to her fetus via the placenta. Worldwide, there are limitations to the data on marijuana use during pregnancy— clinical studies in humans are often heavily confounded by polysubstance use and lifestyle issues, but worrisome trends do emerge in many clinical studies.
Most obstetricians are always concerned with the use of any drug or medicine during pregnancy. For many years obstetricians have been concerned when pregnant women use substances like alcohol, cigarettes and marijuana. Alcohol and smoking should be avoided during pregnancy, as much as possible, out of concern of the effects on the pregnant woman and the developing fetus.
The fetus may be affected by any amount of cannabis taken by the pregnant woman, placing it at a greater risk of complications occurring. The effect of the passive smoking of cannabis and breathing in the smoke of others is not clear, but it should be avoided.
How does cannabis use affect the baby?
Any form of smoking can reduce the supply of oxygen and nutrients to the fetus, which can result in restrictions to the growth of the baby and possibly premature birth, miscarriage and stillbirth. There is some evidence that babies of women who use cannabis during pregnancy may have impaired neurodevelopment.
It has been shown that shortly following the birth, the baby might be irritable and unsettled, and could have difficulties feeding due to marijuana use during pregnancy.
There is still need for more research in the field of marijuana use during pregnancy.
Effects of marijuana use on lactation
There are insufficient data to evaluate the effects of marijuana use on infants during lactation and breastfeeding and, in the absence of such data, marijuana use is discouraged.
Advice to pregnant women
Many pregnant women are often confused over the conflicting information they often hear regarding marijuana use and pregnancy. There is obviously a need for more clinical research in this area, but research is hampered by the fact that marijuana is still an illegal drug in many countries. Very often animal studies are problematic. In studies involving humans, the individuals often have very risky lifestyles and frequently use other illegal drugs. Many also often fear going into a clinical study that might involve them getting into trouble with law enforcement officers.
Obstetricians–gynecologists should be discouraged from prescribing or suggesting the use of marijuana for medicinal purposes during preconception, pregnancy, and lactation. Pregnant women, or women contemplating pregnancy, should be encouraged to discontinue the use of marijuana for medicinal purposes in favour of an alternative therapy for which there are better pregnancy-specific safety data. There are insufficient data to evaluate the effects of marijuana use on infants during lactation and breastfeeding and, in the absence of such data, marijuana use is discouraged.
Conclusion
Using illegal or street drugs during pregnancy, including marijuana, ecstasy, cocaine and heroin, can have a potentially serious effect on the pregnant woman and her unborn fetus.
It is strongly recommended that pregnant women, and their partners, do not use cannabis or any other non-prescribed drug due to the potential harmful effects on the developing baby. Those requiring further information should see their obstetrician.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-five years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
