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 Researchers found that the proportion of U.S. women using pot during
pregnancy more than doubled between 2002 and 2017, according to a
report published in JAMA.
Legalization may at least partly explain why more women are using
marijuana since many assume that means the drug is safe, said the
U.S. study's lead author, Dr. Nora Volkow, director of the National
Institute on Drug Abuse. That attitude, coupled with the lack of
studies on pot can lead to "magical thinking," Volkow said. "It's
very appealing to think that a drug that makes us feel great could
come with no ill effects."
But in the case of pregnant women, "you're talking about the health
not just of the mother, but of a second person who could potentially
be harmed," Volkow said, adding she was especially surprised to find
the proportion of pregnant women using pot daily had more than
tripled.
Volkow's study analyzed data on 467,100 women aged 12 through 44 who
participated in the National Survey on Drug Use and Health.
Between 2002 and 2017, cannabis use rose from 3.4% to 7.0% of
pregnant women overall and daily use increased from 0.9% to 3.4% of
pregnant women. Use during the first trimester increased from 1.8%
to 5.3% and from 0.6% to 2.5% during the second trimester. In
2013-2017, just 0.5% of pregnant women asked if they were using
cannabis at the recommendation of a clinician said they were.
A Canadian study in the same journal found that when pregnant women
used cannabis, their babies were more likely to be born early, at a
lower weight and to be transferred to a neonatal intensive care
unit. Also, the placenta was more likely to detach from the uterine
wall, potentially depriving the baby of oxygen, when mothers used
cannabis. Newborns of cannabis users also had a higher risk of low
scores on a test that evaluates neonatal status.
"These risks are concerning because, for example, being born small
is related to other complications in newborns and higher rates of
certain diseases later in life," said the Canadian study's lead
author, Daniel Corsi, an epidemiologist and adjunct professor at the
University of Ottawa.
Overall, the study involved 5,639 pregnant pot users and 9,427
nonusers enrolled in Ontario's Better Outcomes Registry & Network.
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Corsi suspects many of the women using pot were battling
pregnancy-related nausea, since there was a decline in use after the
first trimester.
"Many women, from social media, are finding that cannabis is good
for morning sickness," Corsi said in an email. "We want to emphasize
a critical message for providers to speak with pregnant women about
cannabis use and communicate that it is not a low-risk activity."
It's possible the numbers of women using pot during pregnancy may
not actually be increasing, but rather that more women are feeling
comfortable admitting they are using marijuana now that it's legal
and more socially acceptable in Canada, said Dr. Kristina Mark of
the University of Maryland School of Medicine in Baltimore.
If that's true, it's good news because women may be more likely to
discuss the issue with their doctors, said Mark, who was not
involved in the new research. "If it's an actual increase, that is
problematic," she said. And that's because no one really knows the
full impact of cannabis on fetuses because there have been so few
studies on the drug due to government regulations.
While both new studies have some weaknesses, in particular their
dependence on self-reported marijuana use, they help shed light on
the issue, Mark said.
The lack of science on the subject is sometimes construed as meaning
that pot is safe, Mark noted, but "absence of evidence is not
evidence of absence."
There are some undeniable facts. First is that the active ingredient
in marijuana, THC, crosses the placenta, so every time a mom smokes
a joint, the baby is doing so, too, Mark said. "For some people that
doesn't seem dramatic," she added. "They say, 'I get high and then I
continue on with my life.' But these babies are being exposed during
a time of rapid development, particularly neurodevelopment."
SOURCE: https://bit.ly/2WWm0C9 , https://bit.ly/2L5Hple and https://bit.ly/2RqjM83
JAMA, online June 18, 2019.
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