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Revision as of 16:30, 27 October 2013 editChhe (talk | contribs)Autopatrolled, Extended confirmed users, Pending changes reviewers, Rollbackers5,405 edits →Potential effects observable in perinatal period: this source says the exact opposite← Previous edit Latest revision as of 08:44, 19 December 2024 edit undoProudbharati (talk | contribs)203 edits The term 'controlled substance' is more accurate and neutral than 'illicit substance', as it reflects the legal status of cannabis in various jurisdictions. 
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{{short description|Effects of cannabis consumption during pregnancy}}
Use of ''']''' (also known as ''marijuana'') '''in ]''' is the subject of various scientific studies, usually regarding whether it has effects on the child later in life.
{{Cannabis sidebar}}
'''Cannabis consumption in pregnancy''' is an important ]. Research has found possible or likely associations between cannabis use and a risk of adverse outcomes in respect of cognitive development, mental health, physical health, and lactation.<ref name=overview/>


Cannabis is the most commonly used controlled substance among pregnant women.<ref name="NCBI">{{cite journal |last1=Wu |first1=CS |last2=Jew |first2=CP |last3=Lu |first3=HC |title=Lasting impacts of prenatal cannabis exposure and the role of endogenous cannabinoids in the developing brain |journal=Future Neurology |date=1 July 2011 |volume=6 |issue=4 |pages=459-480 |pmid=22229018 |pmc=3252200}}</ref>
==Potential effects observable in perinatal period==
A study of 600 mothers that reported smoking cannabis during pregnancy suggested that it was not associated with increased risk of ].<ref name=Fergusson2003>{{cite doi|10.1111/j.1471-0528.2002.01020.x}}</ref>


==Endocannabinoid system==
However, cannabis use during pregnancy has some evidence of causing, delayed commencement of breathing, exaggerated ], tremors, poorer ], poorer ability to adapt to new aspects of the environment, and a ].<ref name=ncpic2011>, fact sheet by the ]. Factsheet published August 1, 2008. Updated October 1, 2011.</ref>
{{See also|Endocannabinoid system}}
The role of the endocannabinoid system (ECS) in female fertility has long been suspected and studied.<ref name=Sun2012/> Most studies through 2013 linking development of the fetus and cannabis show effects of consumption during the gestational period, but abnormalities in the endocannabinoid system during the phase of placental development are also linked with problems in pregnancy.<ref name=Fonseca2013/> According to Sun and Dey (2012), endocannabinoid signaling plays a role in "female reproductive events, including preimplantation embryo development, oviductal embryo transport, embryo implantation, placentation, and parturition".<ref name=Sun2012 >{{cite journal |vauthors=Sun X, Dey SK |title=Endocannabinoid signaling in female reproduction |journal=ACS Chem Neurosci |volume=3 |issue=5 |pages=349–55 |date=May 2012 |pmid=22860202 |pmc=3382454 |doi=10.1021/cn300014e |type=Review }}</ref> Karusu ''et al'' (2011) said that a "clear correlation ... in the actual reproductive tissues of miscarrying versus healthy women has yet to be established. However, the adverse effects of marijuana smoke and THC on reproductive functions point to processes that are modulated by ECS.".<ref name= Karasu2011>{{cite journal |vauthors=Karasu T, Marczylo TH, Maccarrone M, Konje JC |title=The role of sex steroid hormones, cytokines and the endocannabinoid system in female fertility |journal=Hum. Reprod. Update |volume=17 |issue=3 |pages=347–61 |year=2011 |pmid=21227997 |doi=10.1093/humupd/dmq058 |type=Review|doi-access=free }}</ref>


Recent data indicates that endometrial expression of cannabinoid receptors in marijuana smoking mothers is higher than non-smokers.<ref name= Neradugomma2018>{{cite journal |vauthors=Neradugomma NK, Drafton K, O'Day DR, Liao MZ, Han LW, Glass IA, Mao Q |title=Marijuana use differentially affects cannabinoid receptor expression in early gestational human endometrium and placenta |journal=Placenta |volume=66 |pages=36–39 |date=9 May 2018 |pmid= 29884300 |pmc=5995327 |doi=10.1016/j.placenta.2018.05.002|type=Research}}</ref> Keimpema and colleagues (2011) said, "Prenatal cannabis exposure can lead to growth defects during formation of the nervous system"; "annabis impacts the formation and functions of neuronal circuitries by targeting cannabinoid receptors ... By indiscriminately prolonging the "switched-on" period of cannabinoid receptors, cannabis can hijack endocannabinoid signals to evoke molecular rearrangements, leading to the erroneous wiring of neuronal networks".<ref name= Keimpema2011>{{cite journal |vauthors=Keimpema E, Mackie K, Harkany T |title=Molecular model of cannabis sensitivity in developing neuronal circuits |journal=Trends Pharmacol. Sci. |volume=32 |issue=9 |pages=551–61 |date=September 2011 |pmid=21757242 |pmc=3159827 |doi=10.1016/j.tips.2011.05.004|type=Review}}</ref> A report prepared for the ] concluded cannabis and other ]s are contraindicated in pregnancy as they may interact with the endocannabinoid system.<ref name=Fonseca2013>{{cite journal |vauthors=Fonseca BM, Correia-da-Silva G, Almada M, Costa MA, Teixeira NA |title=The Endocannabinoid System in the Postimplantation Period: A Role during Decidualization and Placentation |journal=Int J Endocrinol |volume=2013 |pages=510540 |year=2013 |pmid=24228028 |pmc=3818851 |doi=10.1155/2013/510540|type=Review |doi-access=free }}</ref><ref name="Australia">{{cite book |first1=Jan |last1=Copeland |first2=Saul |last2=Gerber |first3=Wendy |last3=Swift |year=2006 |title=Evidence-based answers to cannabis questions: a review of the literature |location=Canberra |publisher=Australian National Council on Drugs |isbn=978-1-877018-12-1}}{{page needed|date=February 2014}}</ref>
Cannabis use of the father during during conception, pregnancy or postnatally is associated with an increased risk of ] (SIDS) in their infants.<ref name=ncpic2011/>


==Infections== ==Evidence==
In the first six months of life, babies who have had prenatal exposure to cannabis are at greater risk of developing ] and ]s.<ref name=ncpic2011/>


{{asof|2023}} the rising use of cannabis during pregnancy, and the rise in cannabis potency, has become an important ]. Research has found possible or likely associations between cannabis use and a risk of adverse outcomes in respect of cognitive development, mental health, physical health, and lactation.<ref name=overview>{{cite journal |vauthors=Hayer S, Mandelbaum AD, Watch L, Ryan KS, Hedges MA, Manuzak JA, Easley CA, Schust DJ, Lo JO |title=Cannabis and Pregnancy: A Review |journal=Obstet Gynecol Surv |volume=78 |issue=7 |pages=411–428 |date=July 2023 |pmid=37480292 |pmc=10372687 |doi=10.1097/OGX.0000000000001159 |url=}}</ref>
==Neurodevelopmental effects==
In a 1991 study, the development of 59 ]n children was monitored from birth to age 5 using the ] and the ]. The results after five years showed no statistically significant developmental differences between using and non-using mothers. The only difference observed was at 30 days of age, when the children of cannabis-using mothers had better autonomic stability and reflexes.<ref name=pmid1957518>{{cite pmid|1957518 }}</ref> Another similar study on Jamaican children found that children who had been exposed to cannabis prenatally had no significant differences from non-exposed infants at three days of age, and were better in some cognitive tests at one month of age.<ref name="BirthDefects2">{{cite pmid|8121737}}</ref>


===Mental and cognitive===
Some studies have found that children of tobacco and cannabis-smoking mothers more frequently suffer from lasting cognitive deficits, concentration disorders, hyperactivity, and impaired social interactions than non-exposed children of the same age and social background.<ref>{{cite pmid|16095697}}</ref><ref>{{cite pmid|12798960}}</ref> For example, a prospective study in Ottawa that performed follow-up on 145 adolescents came to the result that those with prenatal exposure to cannabis performed worse on abstract designs and spelling.<ref>{{cite doi|10.1080/09297049.2011.628309}}</ref> A report prepared for the ] concluded cannabis and other ]s are contraindicated in pregnancy as it may interact with the ].<ref name="Australia">{{cite book |first1=Jan |last1=Copeland |first2=Saul |last2=Gerber |first3=Wendy |last3=Swift |year=2006 |title=Evidence-based answers to cannabis questions: a review of the literature |location=Canberra |publisher=Australian National Council on Drugs |isbn=978-1-877018-12-1}}</ref><ref>{{cite web|url=http://ncpic.org.au/ncpic/links/information/ |title=Information and Resources • NCPIC |publisher=Ncpic.org.au |date=2011-03-11 |accessdate=2011-04-20}}</ref> However, the previously discussed studies on Jamaican children conflict with this conclusion.


Cannabis use during pregnancy is associated with adverse effects on the ] and ] of offspring.<ref name=impact>{{cite journal |vauthors=Lo JO, Hedges JC, Girardi G |title=Impact of cannabinoids on pregnancy, reproductive health, and offspring outcomes |journal=Am J Obstet Gynecol |volume=227 |issue=4 |pages=571–581 |date=October 2022 |pmid=35662548 |pmc=9530020 |doi=10.1016/j.ajog.2022.05.056 |type=Review}}</ref> The THC exposure resulting from cannabis use interferes with fetal brain development and the male offspring of users are more susceptible to psychotic illness.<ref name=frau>{{cite journal |vauthors=Frau R, Melis M |title=Sex-specific susceptibility to psychotic-like states provoked by prenatal THC exposure: Reversal by pregnenolone |journal=J Neuroendocrinol |volume=35 |issue=2 |pages=e13240 |date=February 2023 |pmid=36810840 |doi=10.1111/jne.13240 |type=Review|hdl=11584/360819 |hdl-access=free }}</ref>
==Childhood cancer==

There is some evidence that prenatal cannabis exposure increases the risk of certain ]s, including ], ] and ].<ref name=ncpic2011/>
=== Epigenetics ===

THC exposure in rats during the prenatal developmental phase may cause ] changes in gene expression, but there is limited knowledge about the risk for psychiatric disorders because of ethical barriers to studying the developing human brain.<ref name=Morris >{{cite journal |vauthors=Morris CV, DiNieri JA, Szutorisz H, Hurd YL |title=Molecular mechanisms of maternal cannabis and cigarette use on human neurodevelopment |journal=Eur. J. Neurosci. |volume=34 |issue=10 |pages=1574–83 |date=November 2011 |pmid=22103415 |pmc=3226730 |doi=10.1111/j.1460-9568.2011.07884.x|type=Review}}</ref> A 2015 review found that cannabis use by pregnant mothers corresponded to impaired brain maturation in their children, and that those children were more predisposed to ]s; these results do not demonstrate causality.<ref>{{cite journal|last1=Alpár|first1=A|last2=Di Marzo|first2=V|last3=Harkany|first3=T|title=At the Tip of an Iceberg: Prenatal Marijuana and Its Possible Relation to Neuropsychiatric Outcome in the Offspring|journal=Biological Psychiatry|date=25 September 2015|doi=10.1016/j.biopsych.2015.09.009|pmid=26549491|volume=79|issue=7|pages=e33–e45|s2cid=18847084}}</ref>

=== Confounding factors ===

The ] stated in 2018 that further research is required to "disentangle" effects of cannabis use from a mother's concomitant drug use and other environmental factors.<ref name="NIDAconfounding">{{cite web |url=https://www.drugabuse.gov/publications/research-reports/marijuana/can-marijuana-use-during-pregnancy-harm-baby |website=National Institute on Drug Abuse |access-date=28 October 2018 |title=Can marijuana use during and after pregnancy harm the baby?}}</ref>

== Developmental observations ==

Developmental observations suggest that CB1 receptors develop only gradually during the ], which block for the ] effects of cannabinoid treatment in the young organism. Therefore, it is suggested that children may respond positively to medicinal applications of cannabinoids without undesirable central effects. Clinical results have been reported in ] and in case studies of children with severe ] or ], and ] (CF) suggesting cannabinoid treatment for ] or ], in order to achieve an improvement of their health condition including improved food intake and reduced ] exacerbations.<ref>{{Cite journal|last=Fride|first=Ester|date=2004|title=The endocannabinoid-CB receptor system: Importance for development and in pediatric disease|url=https://pubmed.ncbi.nlm.nih.gov/15159678/|journal=Neuro Endocrinology Letters|volume=25|issue=1–2|pages=24–30|issn=0172-780X|pmid=15159678}}</ref>

== Morning sickness/hyperemesis gravidarum ==
] (HG), is a debilitating ailment characterized by severe ] and ], ], and ] during pregnancy, and occurs to 1-2% of pregnant women ]. It is a perplexing female mystery for the present-day medical establishment. The frustration is mostly felt by women who are survivors of HG, desperately searching for a cure and increased understanding of this disease. Several pregnant women have revealed their personal experience with cannabis, having used it to relieve symptoms of HG, who would otherwise have become severely ], ], and malnourished due to persistent, uncontrollable vomiting and the inability to eat and ] in their pregnancy.<ref name=":0">{{Cite web|last=Curry|first=Wei-Ni Lin|date=2002|title=Hyperemesis Gravidarum and Clinical Cannabis: To Eat or Not to Eat?|url=http://www.cannabis-med.org/membersonly/mo.php?aid=2002-03-04&fid=2002-03-04-4&mode=p&sid=|website=cannabis-med.org}}</ref><ref>{{Cite journal|last1=Westfall|first1=Rachel E.|last2=Janssen|first2=Patricia A.|last3=Lucas|first3=Philippe|last4=Capler|first4=Rielle|date=2006-02-01|title=Survey of medicinal cannabis use among childbearing women: Patterns of its use in pregnancy and retroactive self-assessment of its efficacy against 'morning sickness'|url=https://www.sciencedirect.com/science/article/pii/S1744388105000939|journal=Complementary Therapies in Clinical Practice|language=en|volume=12|issue=1|pages=27–33|doi=10.1016/j.ctcp.2005.09.006|pmid=16401527|issn=1744-3881}}</ref>

== Society and culture ==
It is a common misconception that cannabis use in pregnancy is low risk; a 2015 study found that 70% of women in the ] assume that using cannabis 1-2 times a week while pregnant is safe.<ref name="pmid25772211">{{cite journal| author=Ko JY, Farr SL, Tong VT, Creanga AA, Callaghan WM| title=Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age. | journal=Am J Obstet Gynecol | year= 2015 | volume= 213 | issue= 2 | pages= 201.e1-201.e10 | pmid=25772211 | doi=10.1016/j.ajog.2015.03.021 | pmc=7469257 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25772211 }} </ref>


==See also== ==See also==
*] *]
*]


==References== ==References==
{{reflist}} {{reflist}}

{{Cannabis}}
{{Pregnancy}}


] ]
]
]

Latest revision as of 08:44, 19 December 2024

Effects of cannabis consumption during pregnancy
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Cannabis consumption in pregnancy is an important public health issue. Research has found possible or likely associations between cannabis use and a risk of adverse outcomes in respect of cognitive development, mental health, physical health, and lactation.

Cannabis is the most commonly used controlled substance among pregnant women.

Endocannabinoid system

See also: Endocannabinoid system

The role of the endocannabinoid system (ECS) in female fertility has long been suspected and studied. Most studies through 2013 linking development of the fetus and cannabis show effects of consumption during the gestational period, but abnormalities in the endocannabinoid system during the phase of placental development are also linked with problems in pregnancy. According to Sun and Dey (2012), endocannabinoid signaling plays a role in "female reproductive events, including preimplantation embryo development, oviductal embryo transport, embryo implantation, placentation, and parturition". Karusu et al (2011) said that a "clear correlation ... in the actual reproductive tissues of miscarrying versus healthy women has yet to be established. However, the adverse effects of marijuana smoke and THC on reproductive functions point to processes that are modulated by ECS.".

Recent data indicates that endometrial expression of cannabinoid receptors in marijuana smoking mothers is higher than non-smokers. Keimpema and colleagues (2011) said, "Prenatal cannabis exposure can lead to growth defects during formation of the nervous system"; "annabis impacts the formation and functions of neuronal circuitries by targeting cannabinoid receptors ... By indiscriminately prolonging the "switched-on" period of cannabinoid receptors, cannabis can hijack endocannabinoid signals to evoke molecular rearrangements, leading to the erroneous wiring of neuronal networks". A report prepared for the Australian National Council on Drugs concluded cannabis and other cannabinoids are contraindicated in pregnancy as they may interact with the endocannabinoid system.

Evidence

As of 2023 the rising use of cannabis during pregnancy, and the rise in cannabis potency, has become an important public health issue. Research has found possible or likely associations between cannabis use and a risk of adverse outcomes in respect of cognitive development, mental health, physical health, and lactation.

Mental and cognitive

Cannabis use during pregnancy is associated with adverse effects on the mental health and cognitive performance of offspring. The THC exposure resulting from cannabis use interferes with fetal brain development and the male offspring of users are more susceptible to psychotic illness.

Epigenetics

THC exposure in rats during the prenatal developmental phase may cause epigenetic changes in gene expression, but there is limited knowledge about the risk for psychiatric disorders because of ethical barriers to studying the developing human brain. A 2015 review found that cannabis use by pregnant mothers corresponded to impaired brain maturation in their children, and that those children were more predisposed to neurodevelopmental disorders; these results do not demonstrate causality.

Confounding factors

The National Institute on Drug Abuse stated in 2018 that further research is required to "disentangle" effects of cannabis use from a mother's concomitant drug use and other environmental factors.

Developmental observations

Developmental observations suggest that CB1 receptors develop only gradually during the postnatal period, which block for the psychoactive effects of cannabinoid treatment in the young organism. Therefore, it is suggested that children may respond positively to medicinal applications of cannabinoids without undesirable central effects. Clinical results have been reported in pediatric oncology and in case studies of children with severe neurological disease or brain trauma, and cystic fibrosis (CF) suggesting cannabinoid treatment for children or young adults, in order to achieve an improvement of their health condition including improved food intake and reduced inflammatory exacerbations.

Morning sickness/hyperemesis gravidarum

Hyperemesis Gravidarum (HG), is a debilitating ailment characterized by severe nausea and vomiting, malnutrition, and weight loss during pregnancy, and occurs to 1-2% of pregnant women globally. It is a perplexing female mystery for the present-day medical establishment. The frustration is mostly felt by women who are survivors of HG, desperately searching for a cure and increased understanding of this disease. Several pregnant women have revealed their personal experience with cannabis, having used it to relieve symptoms of HG, who would otherwise have become severely emaciated, dehydrated, and malnourished due to persistent, uncontrollable vomiting and the inability to eat and drink in their pregnancy.

Society and culture

It is a common misconception that cannabis use in pregnancy is low risk; a 2015 study found that 70% of women in the United States assume that using cannabis 1-2 times a week while pregnant is safe.

See also

References

  1. ^ Hayer S, Mandelbaum AD, Watch L, Ryan KS, Hedges MA, Manuzak JA, Easley CA, Schust DJ, Lo JO (July 2023). "Cannabis and Pregnancy: A Review". Obstet Gynecol Surv. 78 (7): 411–428. doi:10.1097/OGX.0000000000001159. PMC 10372687. PMID 37480292.
  2. Wu, CS; Jew, CP; Lu, HC (1 July 2011). "Lasting impacts of prenatal cannabis exposure and the role of endogenous cannabinoids in the developing brain". Future Neurology. 6 (4): 459–480. PMC 3252200. PMID 22229018.
  3. ^ Sun X, Dey SK (May 2012). "Endocannabinoid signaling in female reproduction". ACS Chem Neurosci (Review). 3 (5): 349–55. doi:10.1021/cn300014e. PMC 3382454. PMID 22860202.
  4. ^ Fonseca BM, Correia-da-Silva G, Almada M, Costa MA, Teixeira NA (2013). "The Endocannabinoid System in the Postimplantation Period: A Role during Decidualization and Placentation". Int J Endocrinol (Review). 2013: 510540. doi:10.1155/2013/510540. PMC 3818851. PMID 24228028.
  5. Karasu T, Marczylo TH, Maccarrone M, Konje JC (2011). "The role of sex steroid hormones, cytokines and the endocannabinoid system in female fertility". Hum. Reprod. Update (Review). 17 (3): 347–61. doi:10.1093/humupd/dmq058. PMID 21227997.
  6. Neradugomma NK, Drafton K, O'Day DR, Liao MZ, Han LW, Glass IA, Mao Q (9 May 2018). "Marijuana use differentially affects cannabinoid receptor expression in early gestational human endometrium and placenta". Placenta (Research). 66: 36–39. doi:10.1016/j.placenta.2018.05.002. PMC 5995327. PMID 29884300.
  7. Keimpema E, Mackie K, Harkany T (September 2011). "Molecular model of cannabis sensitivity in developing neuronal circuits". Trends Pharmacol. Sci. (Review). 32 (9): 551–61. doi:10.1016/j.tips.2011.05.004. PMC 3159827. PMID 21757242.
  8. Copeland, Jan; Gerber, Saul; Swift, Wendy (2006). Evidence-based answers to cannabis questions: a review of the literature. Canberra: Australian National Council on Drugs. ISBN 978-1-877018-12-1.
  9. Lo JO, Hedges JC, Girardi G (October 2022). "Impact of cannabinoids on pregnancy, reproductive health, and offspring outcomes". Am J Obstet Gynecol (Review). 227 (4): 571–581. doi:10.1016/j.ajog.2022.05.056. PMC 9530020. PMID 35662548.
  10. Frau R, Melis M (February 2023). "Sex-specific susceptibility to psychotic-like states provoked by prenatal THC exposure: Reversal by pregnenolone". J Neuroendocrinol (Review). 35 (2): e13240. doi:10.1111/jne.13240. hdl:11584/360819. PMID 36810840.
  11. Morris CV, DiNieri JA, Szutorisz H, Hurd YL (November 2011). "Molecular mechanisms of maternal cannabis and cigarette use on human neurodevelopment". Eur. J. Neurosci. (Review). 34 (10): 1574–83. doi:10.1111/j.1460-9568.2011.07884.x. PMC 3226730. PMID 22103415.
  12. Alpár, A; Di Marzo, V; Harkany, T (25 September 2015). "At the Tip of an Iceberg: Prenatal Marijuana and Its Possible Relation to Neuropsychiatric Outcome in the Offspring". Biological Psychiatry. 79 (7): e33 – e45. doi:10.1016/j.biopsych.2015.09.009. PMID 26549491. S2CID 18847084.
  13. "Can marijuana use during and after pregnancy harm the baby?". National Institute on Drug Abuse. Retrieved 28 October 2018.
  14. Fride, Ester (2004). "The endocannabinoid-CB receptor system: Importance for development and in pediatric disease". Neuro Endocrinology Letters. 25 (1–2): 24–30. ISSN 0172-780X. PMID 15159678.
  15. Curry, Wei-Ni Lin (2002). "Hyperemesis Gravidarum and Clinical Cannabis: To Eat or Not to Eat?". cannabis-med.org.
  16. Westfall, Rachel E.; Janssen, Patricia A.; Lucas, Philippe; Capler, Rielle (2006-02-01). "Survey of medicinal cannabis use among childbearing women: Patterns of its use in pregnancy and retroactive self-assessment of its efficacy against 'morning sickness'". Complementary Therapies in Clinical Practice. 12 (1): 27–33. doi:10.1016/j.ctcp.2005.09.006. ISSN 1744-3881. PMID 16401527.
  17. Ko JY, Farr SL, Tong VT, Creanga AA, Callaghan WM (2015). "Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age". Am J Obstet Gynecol. 213 (2): 201.e1-201.e10. doi:10.1016/j.ajog.2015.03.021. PMC 7469257. PMID 25772211.{{cite journal}}: CS1 maint: multiple names: authors list (link)
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