Lesson 10

Understanding Marijuana Use

Understanding Marijuana Use: 'Tip of the Iceberg' (3)

Along with being concerned about marijuana use during pregnancy, there is also the issue of co-use of other drugs to be concerned about.
 
Marijuana is often used along with other drugs like alcohol and tobacco, as well as opioids like prescription drugs, or stimulants like cocaine and methamphetamine.
 
The idea that it is “just marijuana” is not an accurate perception. There is still a lot to be concerned about.
 
Marijuana use in pregnancy is frequently accompanied by other forms of drug use:

• Nearly 11% identified as using opioids as well
• About 10% identified as using stimulants as well
• 13% identified as using alcohol as well
• 74% identified as smoking cigarettes as well (1,4)

Marijuana Prenatal Exposure

What do we know about the impact of marijuana use during pregnancy? We now know that opioids have an impact on a fetus’ development. We also know that alcohol and tobacco are dangerous drugs for all pregnant women.
 
Similar to other drugs used during pregnancy, marijuana crosses the barriers that a pregnant woman’s body puts up to protect the fetus. Evidence of cannabis (another term for marijuana) is found in the placenta, amniotic fluid, and the fetus.
 
When a pregnant woman eats, drinks, smokes or vapes marijuana, she is exposing herself and her fetus to varying levels of THC (delta-9-tetrahydrocannabinol) and cannabidiol (CBD). THC and CBD are two chemicals found in marijuana that can impact the brain. THC is the component of marijuana responsible for euphoria and intoxication, and although CBD is not intoxicating, its long-term effects are largely unknown. It is important to note that most CBD products are untested and of uncertain purity. In some places specific levels of THC are allowed in CBD products. Make sure to read the labels on CBD products. Delta-8 is another unregulated substance related to marijuana that is available to buy. Because there is little current research on Delta-8 its long-term effects are also unknown.

One significant issue of concern from marijuana use during pregnancy is preterm delivery among women who use marijuana while pregnant.
 
There is an increased risk for preterm delivery among women who use marijuana while pregnant.6 Women who use marijuana at least weekly during pregnancy are most at risk for delivering a baby preterm. (7)

There have been issues with the development of babies’ hearts when pregnant women use marijuana but overall marijuana isn’t seen at this time as a cause of major birth defects. This could however change as we collect more research in the future. The biggest issues we are talking about currently are growth problems.

There is also research suggesting that pregnant individuals using marijuana more often than weekly were at a high risk for having pregnancies with these problems. (11, 12)

Marijuana Growth Effects

In addition to preterm birth, we have the most research on the connection between marijuana use during pregnancy and how it impacts the growth of a developing baby. There have been issues with the development of babies hearts when pregnant women use marijuana but overall marijuana isn't seen at this time as a cause of major birth defects. This could however change as we collect more research in the future. The biggest issues we are talking about currently are growth problems.

Babies prenatally exposed to marijuana have smaller birth lengths and head circumferences, as well as lower birth weights. (8-9)
 
These effects are most pronounced among women who used marijuana in their first and second trimesters versus only third trimester use. (7) There is also research suggesting that pregnant individuals using marijuana more often than weekly were at a high risk for having pregnancies with problems. (11,12)

Marijuana and Newborns

Since marijuana use during pregnancy is almost always part of a polysubstance use issue, it makes it a bit more difficult to isolate the effects of marijuana from mom’s other drug use.
 
However, people who observe newborns that have been prenatally exposed to marijuana have noted some differences in the behaviors of those newborns. Difficulty soothing, more crying, and more hand to mouth behaviors have been noted among newborns prenatally exposed to marijuana. This may mean that marijuana use during pregnancy affects a newborn baby’s ability to regulate itself when compared to newborns who have not been prenatally exposed to cannabis/marijuana.

Marijuana and Later Development

There has been a recent research study that suggests marijuana use during pregnancy could be related to a later diagnosis of Autism Spectrum Disorders in children. (11,13)

Marijuana and Pregnancy Recent Warnings

There have been multiple recent recommendations and advisories warning of the risks of marijuana use in pregnancy.
 
ACOG, or the American College of Obstetrics and Gynecologists, holds that “Women who are pregnant or contemplating pregnancy should be encouraged to discontinue marijuana use. Women reporting marijuana use should be counseled about concerns regarding potential adverse health consequences of continued use during pregnancy.” (7)
 
In 2018, AAP, or The American Academy of Pediatrics stated, “it is important to advise all adolescents and young women that if they become pregnant, marijuana should not be used during pregnancy.” (10)
 
In August 2019, the U.S. Surgeon General issued an advisory: “Marijuana Use and the Developing Brain” in an effort to raise awareness of the known and potential harms to developing brains posed by the increasing availability of highly potent marijuana in multiple concentrated forms. (5)