With the legalization of recreational marijuana in many states, we anticipate more
women will be using and self-reporting marijuana use in pregnancy. Marijuana is the
most common illicit drug used in pregnancy, with a prevalence of use ranging from
3% to 30% in various populations. Marijuana freely crosses the placenta and is found
in breast milk. It may have adverse effects on both perinatal outcomes and fetal neurodevelopment.
Specifically, marijuana may be associated with fetal growth restriction, stillbirth,
and preterm birth. However, data are far from uniform regarding adverse perinatal
outcomes. Existing studies are plagued by confounding by tobacco and other drug exposures
as well as sociodemographic factors. In addition, there is a lack of quantification
of marijuana exposure by the trimester of use and a lack of corroboration of maternal
self-report with biological sampling, which contributes to the heterogeneity of study
results. There is an emerging body of evidence indicating that marijuana may cause
problems with neurological development, resulting in hyperactivity, poor cognitive
function, and changes in dopaminergic receptors. In addition, contemporary marijuana
products have higher quantities of delta-9-tetrahydrocannabinol than in the 1980s
when much of the marijuana research was completed. The effects on the pregnancy and
fetus may therefore be different than those previously seen. Further research is needed
to provide evidence-based counseling of women regarding the anticipated outcomes of
marijuana use in pregnancy. In the meantime, women should be advised not to use marijuana
in pregnancy or while lactating.
Key words
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Article Info
Publication History
Published online: May 15, 2015
Accepted:
May 13,
2015
Received in revised form:
May 5,
2015
Received:
March 12,
2015
Footnotes
The authors report no conflict of interest.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
