Cannabis use in pregnancy and breastfeeding: The pharmacist’s role
Erin Davis | Tiffany Lee | John T. Weber | Shawn Bugden
Memorial University of Newfoundland
In addition, 60% of respondents who used marijuana for medical purposes indicated that either it had no effect on their ability to drive or that “it depends.”6 Survey data from the United States estimate that 5% to 35% of pregnant and breastfeeding women are using marijuana.7,8 Ten percent of these women indicated that they would have used marijuana more during pregnancy if it had been legal.7 Marijuana use does tend to drop off as pregnancy progresses, similar to the trend seen with opioid use in pregnant women.9,10 One study showed that the percentage of pregnant women who believed smoking marijuana posed “no risk” increased from 3.5% to 16.5% over a 7-year study.11 Pregnant women may also be receiving advice to consume marijuana for nausea associated with pregnancy, as reported by a study in Colorado. Cannabis in pregnancy and breastfeeding THC, a small highly lipophilic molecule, is known to cross the placental barrier into fetal circulation and accumulate with repeated exposure.14 There have also been a number of studies demonstrating that THC and CBD may be detectable in human milk up to 6 days after use and that THC accumulates in breastmilk with chronic, heavy exposure.3,4 It is also known that THC is rapidly distributed to and stored in the brain and fat tissues and has an estimated half-life of 4.1 days in chronic cannabis users.15 The potential for cannabinoids to adversely affect developing fetal and infant brains led the Society of Obstetricians and Gynecologists of Canada and the Motherisk program, formerly run through SickKids, to recommend that all pregnant and breastfeeding women abstain from marijuana use.16,17 The Canadian Pediatric Society has not published a statement on the use of marijuana in pregnancy and breastfeeding, but the American Association of Pediatrics has spoken out on the issue and recommended education and abstinence from cannabis products during pregnancy and breastfeeding.18 Pregnancy The literature on maternal use of marijuana in pregnancy has shown mixed results on children’s development. When women who use marijuana during pregnancy also use other substances such as alcohol and nicotine, the effects of these agents can be difficult to distinguish.37 In addition, the potency of THC in marijuana today is much greater than it was in the 1980s and 1990s when much of the data on this topic were published.38 Further research is required in several areas, including the pharmacokinetics of THC and other components of marijuana in breastmilk and in breastfeeding infants, the effects of varying THC/CBD doses on outcomes in pregnancy and breastfeeding and the effect of the timing of exposure and chronicity of parental cannabis use on the type and severity of potential deficits in child development. Marijuana use and its effects in pregnancy. Marijuana use and its effects in pregnancy.
https://www.ncbi.nlm.nih.gov/pmc/articles/7079319