{"id":137,"date":"2021-11-16T16:12:39","date_gmt":"2021-11-16T16:12:39","guid":{"rendered":"https:\/\/victoryrejuvenationcenter.com\/?p=137"},"modified":"2023-11-24T12:01:15","modified_gmt":"2023-11-24T12:01:15","slug":"clinician-insight-on-the-use-of-cannabis-during-pregnancy","status":"publish","type":"post","link":"https:\/\/victoryrejuvenationcenter.com\/2021\/11\/16\/clinician-insight-on-the-use-of-cannabis-during-pregnancy\/","title":{"rendered":"Clinician Insight on the Use of Cannabis during Pregnancy"},"content":{"rendered":"

By Victory Rejuvenation Center<\/em><\/strong><\/p>\n

One of the frequent questions asked at the clinic is whether or not it is ok to use cannabis while pregnant. Cannabis use is rising in popularity worldwide. More people are starting to connect with the plant and use it for a wide range of conditions and situations. A large subset of people want to know if cannabis can be used safely during pregnancy, or not. As is the case with many great questions, there isn\u2019t a firm yes or no to send people on their way with. We will highlight what is known about cannabis in pregnancy, the role of the endocannabinoid system in gestation, and considerations before thinking about using cannabis while pregnant. <\/p>\n

Firstly and most importantly, the best things for pregnant women are healthy whole foods, clean water, and fresh air. They should limit white sugar and avoid processed foods with no nutritional value. It is advised not to ingest or smoke drugs of any kind while pregnant. This includes tobacco, alcohol, caffeine, cannabis, pharmaceuticals, opiates, and methamphetamines. That is the long and short of it. Now for specifics on the pregnancy and cannabis question. <\/p>\n

Cannabis is the third most commonly used substance during pregnancy. [1] Pregnant women use cannabis at a higher rate during the first trimester with many reporting stopping or significantly decreasing consumption by the third trimester. [2,3] Throughout the literature, self-reported rates of cannabis use in pregnancy range from 1.2% to 27%. [2] Is this increase due to cannabis use being more in the open now? Or are more pregnant women actually using cannabis during pregnancy? The answer is probably both, with potentially more women admitting to it!<\/p>\n

Research in pregnancy is difficult. There are ethical issues abound. There are also many confounding factors that make studying the effects of one substance incredibly challenging. Some of these considerations include the genetics and nutrition of the parents, using tobacco, alcohol, pharmaceuticals, or over-the-counter drugs, stress, religious beliefs, etc. Many of these can adversely impact pregnancy in their own right. There is also the possibility of synergistic effects when substances are used together. Ideally studies would be done on pregnant women who only use cannabis during pregnancy and no other substance. As you can imagine, that is difficult to do. <\/p>\n

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The Endocannabinoid System & Pregnancy<\/h3>\n

Cannabis has been used in obstetrics and women\u2019s health for thousands of years. [4] The endocannabinoid system (ECS) is important for the entire nine months of pregnancy. The concern about cannabis use for unborn fetuses and newborns stems from the fact that cannabinoids cross the placenta. [5] The ECS plays an essential role for development and survival during three developmental stages of pregnancy. The first stage is throughout early gestation. Successful embryonal passage through the oviduct and implantation into the uterus requires critical enzymatic control of the endocannabinoids, specifically anandamide. Anandamide is an endocannabinoid, meaning those that are produced within the body. [6,7,8] <\/p>\n

The second stage is during fetal life. Endocannabinoids and the CB1 receptor are important for brain development. Anandamide protects the developing brain from naturally occurring trauma-induced neuronal loss. The third stage is postnatally, where CB1 receptor activation by 2-AG (another endocannabinoid) was found to play a critical role in the initiation of milk suckling in mouse pups. This was possibly due to enabling innovation and\/or activation of the tongue muscles. [6,7,8] <\/p>\n

It is clear to see the potential for adverse fetal outcomes with prenatal cannabis exposure. There are preclinical studies that show harm, those that show no ill effects, and several that show actual benefit. There are clinical studies demonstrating potential harm and those that show no harm. [6,9,10] In general, the results are inconclusive. <\/p>\n

Areas of Concern<\/h3>\n

The apprehension concerning cannabis use in pregnancy includes low birth weight, preterm babies, neonatal intensive care unit (NICU) admissions, neurodevelopmental outcomes, and poor school performance. There is also the consideration of predisposing children to more addiction disorders and depression, impaired executive functioning, memory and cognition, or mental illness. [11] <\/p>\n

The only prospective clinical study that examined pure cannabis use in pregnancy was published by Dreher and colleagues in 1994. This pivotal research is highly referenced to this day. Dreher\u2019s investigation demonstrated that cannabis-exposed babies were less irritable, more stable and socially responsive, and had better reflexes. The course of the pregnancies were similar in each group. The two groups of newborns were not significantly different according to physical examination data including birth weight and length, and gestational age. At a five year follow up, the result demonstrated that there were no significant differences in developmental testing outcomes. Dreher reported that children who were exposed to cannabis did well in preschool and had solid attendance. [12]<\/p>\n

More recent investigation includes the NASEM report of 2017<\/a> which reviewed more than 10,000 studies done between 1999 and 2016. Researchers reported prenatal, perinatal, and neonatal findings that found:<\/p>\n