Display options
Cite
Gesterling L, Bradford H. Cannabis Use in Pregnancy: A State of the Science Review. J Midwifery Womens Health. 2021;doi: 10.1111/jmwh.13293.
Gesterling, L., & Bradford, H. (2021). Cannabis Use in Pregnancy: A State of the Science Review. Journal of midwifery & women's health, . https://doi.org/10.1111/jmwh.13293
Gesterling, Lisa, and Bradford, Heather. "Cannabis Use in Pregnancy: A State of the Science Review." Journal of midwifery & women's health vol. (2021). doi: https://doi.org/10.1111/jmwh.13293
Gesterling L, Bradford H. Cannabis Use in Pregnancy: A State of the Science Review. J Midwifery Womens Health. 2021 Nov 28; doi: 10.1111/jmwh.13293. Epub 2021 Nov 28. PMID: 34841645.
Copy Download .nbib Format: NLM
Share it on

J Midwifery Womens Health. 2021 Nov 28; doi: 10.1111/jmwh.13293. Epub 2021 Nov 28.

Cannabis Use in Pregnancy: A State of the Science Review.

Journal of midwifery & women's health

Lisa Gesterling, Heather Bradford

Affiliations

  1. Nurse-Midwifery/Women's Health Nurse Practitioner Program, Georgetown University School of Nursing and Health Studies, Washington, DC.

PMID: 34841645 DOI: 10.1111/jmwh.13293

Abstract

With a growing number of states legalizing recreational use, cannabis consumption during pregnancy is increasing. Population-based data and rigorous studies examining the association of cannabis use in pregnancy with perinatal outcomes are limited, but trends include preterm prelabor rupture of membranes, placenta previa, and an increased length of hospital stay. Neonates of pregnant persons who used cannabis during their pregnancy can be at increased risk of low birth weight, preterm birth, neonatal intensive care unit admission, neurocognitive deficits, and infectious and neurologic morbidity and mortality. This state of the science review examines the prevalence of cannabis use in pregnancy, its pharmacodynamics and how that is influenced by pregnancy, and associated adverse perinatal and neonatal outcomes. Implications for health care providers caring for pregnant persons using cannabis, especially in legalized states, are discussed.

© 2021 by the American College of Nurse-Midwives.

Keywords: cannabinoids; cannabis; cannabis smoking; fetus; maternal health; neonate; pregnancy; prenatal care

References

  1. Solomon R. Racism and its effect on cannabis research. Cannabis Cannabinoid Res. 2020;5(1):2-5. https://doi.org/10.1089/can.2019.0063 - PubMed
  2. Map of marijuana legality by state. DISA Global Solutions. Accessed June 8, 2021. https://disa.com/map-of-marijuana-legality-by-state - PubMed
  3. Gomez S. All the states that legalized marijuana. Addiction Center. November 12, 2020. Accessed June 8, 2021. https://www.addictioncenter.com/news/2020/11/states-legalized-marijuana/ - PubMed
  4. Foeller ME, Lyell DJ. Marijuana use in pregnancy: concerns in an evolving era. J Midwifery Womens Health. 2017;62(3):363-367. https://doi.org/10.1111/jmwh.12631 - PubMed
  5. Gnofam M, Allshouse AA, Stickrath EH, Metz TD. Impact of marijuana legalization on prevalence of maternal marijuana use and perinatal outcomes. Am J Perinatol. 2020;37(1):59-65. https://doi.org/10.1055/s-0039-1696719 - PubMed
  6. American College of Obstetricians and Gynecologists Committee on Obstetric Practice. Committee opinion no. 637: Marijuana use during pregnancy and lactation. Obstet Gynecol. 2015;126(1):234-238. https://doi.org/10.1097/01.AOG.0000467192.89321.a6 - PubMed
  7. Behnke M, Smith VC; Committee on Substance Abuse; Committee on Fetus and Newborn. Prenatal substance abuse: short- and long-term effects on the exposed fetus. Pediatrics. 2013;131(3):e1009-e1024. https://doi.org/10.1542/peds.2012-3931 - PubMed
  8. Barbosa-Leiker C, Burduli E, Smith CL, Brooks O, Orr M, Gartstein M. Daily cannabis use during pregnancy and postpartum in a state with legalized recreational cannabis. J Addict Med. 2020;14(6):467-474. https://doi.org/10.1097/adm.0000000000000625 - PubMed
  9. Dickson B, Mansfield C, Guiahi M, et al. Recommendations from cannabis dispensaries about first-trimester cannabis use. Obstet Gynecol. 2018;131(6):1031-1038. https://doi.org/10.1097/aog.0000000000002619 - PubMed
  10. Hartman M. Marijuana overview. National Conference of State Legislatures. April 8, 2021. Accessed June 8, 2021. https://www.ncsl.org/research/civil-and-criminal-justice/marijuana-overview.aspx - PubMed
  11. Conner SN, Bedell V, Lipsey K, Macones GA, Cahill AG, Tuuli MG. Maternal marijuana use and adverse neonatal outcomes: a systematic review and meta-analysis. Obstet Gynecol. 2016;128(4):713-723. https://doi.org/10.1097/aog.0000000000001649 - PubMed
  12. Mark K, Gryczynski J, Axenfeld E, Schwartz RP, Terplan M. Pregnant women's current and intended cannabis use in relation to their views toward legalization and knowledge of potential harm. J Addict Med. 2017;11(3):211-216. https://doi.org/10.1097/adm.0000000000000299 - PubMed
  13. Reece AS, Hulse GK. Canadian cannabis consumption and patterns of congenital anomalies: an ecological geospatial analysis. J Addict Med. 2020;14(5):e195-e210. https://doi.org/10.1097/adm.0000000000000638 - PubMed
  14. Jones JT, Baldwin A, Shu I. A comparison of meconium screening outcomes as an indicator of the impact of state-level relaxation of marijuana policy. Drug Alcohol Depend. 2015;156:e104-e105. https://doi.org/10.1016/j.drugalcdep.2015.07.290 - PubMed
  15. Ko JY, Farr SL, Tong VT, Creanga AA, Callaghan WM. Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age. Am J Obstet Gynecol. 2015;213(2):201.e1-201.e10. https://doi.org/10.1016/j.ajog.2015.03.021 - PubMed
  16. American Psychiatric Association. Substance-Related and Addictive Disorders. American Psychiatric Association; 2013. Accessed July 29, 2021. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM-5-Substance-Use-Disorder.pdf - PubMed
  17. Petrangelo A, Czuzoj-Shulman N, Balayla J, Abenhaim HA. Cannabis abuse or dependence during pregnancy: a population-based cohort study on 12 million births. J Obstet Gynaecol Can. 2019;41(5):623-630. https://doi.org/10.1016/j.jogc.2018.09.009 - PubMed
  18. Volkow ND, Han B, Compton WM, McCance-Katz EF. Self-reported medical and nonmedical cannabis use among pregnant women in the United States. JAMA. 2019;322(2):167-169. https://doi.org/10.1001/jama.2019.7982 - PubMed
  19. Young-Wolff KC, Sarovar V, Tucker LY, et al. Trends in marijuana use among pregnant women with and without nausea and vomiting in pregnancy, 2009-2016. Drug Alcohol Depend. 2019;196:66-70. https://doi.org/10.1016/j.drugalcdep.2018.12.009 - PubMed
  20. Marinol (dronabinol). Prescribing information. Abbvie Inc.; 2017. Accessed June 8, 2021. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018651s029lbl.pdf - PubMed
  21. Cesamet (nabilone). Prescribing information. Valeant Pharmaceuticals; 2016. Accessed June 8, 2021. https://www.accessdata.fda.gov/drugsatfda_docs/label/2006/018677s011lbl.pdf - PubMed
  22. Szutorisz H, Hurd YL. High times for cannabis: epigenetic imprint and its legacy on brain and behavior. Neurosci Biobehav Rev. 2018;85:93-101. https://doi.org/10.1016/j.neubiorev.2017.05.011 - PubMed
  23. ElSohly MA, Chandra S, Radwan M, Majumdar CG, Church JC. A comprehensive review of cannabis potency in the United States in the last decade. Biol Psychiatry Cogn Neurosci Neuroimaging. 2021;6(6):603-606. https://doi.org/10.1016/j.bpsc.2020.12.016 - PubMed
  24. Crume TL, Juhl AL, Brooks-Russell A, Hall KE, Wymore E, Borgelt LM. Cannabis use during the perinatal period in a state with legalized recreational and medical marijuana: the association between maternal characteristics, breastfeeding patterns, and neonatal outcomes. J Pediatr. 2018;197:90-96. https://doi.org/10.1016/j.jpeds.2018.02.005 - PubMed
  25. Almada M, Costa L, Fonseca B, et al. The endocannabinoid 2-arachidonoylglycerol promotes endoplasmic reticulum stress in placental cells. Reproduction. 2020;160(2):171-180. https://doi.org/10.1530/rep-19-0539 - PubMed
  26. Brents LK. Marijuana, the endocannabinoid system and the female reproductive system. Yale J Biol Med. 2016;89(2):175-191. - PubMed
  27. Grant KS, Petroff R, Isoherranen N, Stella N, Burbacher TM. Cannabis use during pregnancy: pharmacokinetics and effects on child development. Pharmacol Ther. 2018;182:133-151. https://doi.org/10.1016/j.pharmthera.2017.08.014 - PubMed
  28. Warshak CR, Regan J, Moore B, Magner K, Kritzer S, Van Hook J. Association between marijuana use and adverse obstetrical and neonatal outcomes. J Perinatol. 2015;35(12):991-995. https://doi.org/10.1038/jp.2015.120 - PubMed
  29. Dong C, Chen J, Harrington A, Vinod KY, Hegde ML, Hegde VL. Cannabinoid exposure during pregnancy and its impact on immune function. Cell Mol Life Sci. 2019;76(4):729-743. https://doi.org/10.1007/s00018-018-2955-0 - PubMed
  30. Alaniz VI, Liss J, Metz TD, Stickrath E. Cannabinoid hyperemesis syndrome: a cause of refractory nausea and vomiting in pregnancy. Obstet Gynecol. 2015;125(6):1484-1486. https://doi.org/10.1097/aog.0000000000000595 - PubMed
  31. Nguyen TAH, Palmer MC. Cannabinoid hyperemesis syndrome in pregnancy: a case report and treatment overview. J Clin Gastroenterol Treat. 2019;5(2):069. https://doi.org/10.23937/2469-584x/1510069 - PubMed
  32. Bailey BA, Wood DL, Shah D. Impact of pregnancy marijuana use on birth outcomes: results from two matched population-based cohorts. J Perinatol. 2020;40(10):1477-1482. https://doi.org/10.1038/s41372-020-0643-z - PubMed
  33. Howard DS, Dhanraj DN, Devaiah CG, Lambers DS. Cannabis use based on urine drug screens in pregnancy and its association with infant birth weight. J Addict Med. 2019;13(6):436-441. https://doi.org/10.1097/adm.0000000000000516 - PubMed
  34. Metz TD, Allshouse AA, Hogue CJ, et al. Maternal marijuana use, adverse pregnancy outcomes, and neonatal morbidity. Am J Obstet Gynecol. 2017;217(4):478.e1-478.e8. https://doi.org/10.1016/j.ajog.2017.05.050 - PubMed
  35. O'Connor AB, Kelly BK, O'Brien LM. Maternal and infant outcomes following third trimester exposure to marijuana in opioid dependent pregnant women maintained on buprenorphine. Drug Alcohol Depend. 2017;180:200-203. https://doi.org/10.1016/j.drugalcdep.2017.08.012 - PubMed
  36. Ryan SA, Ammerman SD, O'Connor ME; Committee on Substance Use and Prevention; Section on Breastfeeding. Marijuana use during pregnancy and breastfeeding: implications for neonatal and childhood outcomes. Pediatrics. 2018;142(3):e20181889. https://doi.org/10.1542/peds.2018-1889 - PubMed
  37. US Preventive Services Task Force; Krist AH, Davidson KW, Mangione CM, et al. Screening for unhealthy drug use: US Preventive Services Task Force recommendation statement. JAMA. 2020;323(22):2301-2309. https://doi.org/10.1001/jama.2020.8020 - PubMed
  38. National Institute on Drug Abuse. Resource Guide: Screening for Drug Use in General Medical Settings. National Institute on Drug Abuse; 2012. Accessed June 8, 2021. https://archives.drugabuse.gov/publications/resource-guide-screening-drug-use-in-general-medical-settings/nida-quick-screen - PubMed
  39. Terplan M, Minkoff H. Neonatal abstinence syndrome and ethical approaches to the identification of pregnant women who use drugs. Obstet Gynecol. 2017;129(1):164-167. https://doi.org/10.1097/aog.0000000000001781 - PubMed
  40. Bayrampour H, Zahradnik M, Lisonkova S, Janssen P. Women's perspectives about cannabis use during pregnancy and the postpartum period: an integrative review. Prev Med. 2019;119:17-23. https://doi.org/10.1016/j.ypmed.2018.12.002 - PubMed
  41. Jarlenski M, Zank J, Tarr J, Chang JC. Public health messages about perinatal marijuana use in an evolving policy context. Subst Abus. 2017;38(1):48-54. https://doi.org/10.1080/08897077.2016.1268240 - PubMed
  42. Substance Abuse and Mental Health Services Administration. A Guide to Substance Abuse Services for Primary Care Clinicians. Substance Abuse and Mental Health Services Administration; 1997. Accessed April 22, 2020. https://www.ncbi.nlm.nih.gov/books/NBK64827/ - PubMed
  43. Child Information Welfare Gateway. Definitions of Child Abuse and Neglect. Children's Bureau, US Department of Health and Human Services; 2019. Accessed November 23, 2020. https://www.childwelfare.gov/pubPDFs/define.pdf#page=6&view=Summaries%20of%20State%20laws - PubMed
  44. Berra A, Kamo S, Mohnot S, et al. The association between antenatal maternal self-reported substance use, maternal characteristics, and obstetrical variables. J Addict Med. 2019;13(6):464-469. https://doi.org/10.1097/adm.0000000000000521 - PubMed
  45. Thompson R, DeJong K, Lo J. Marijuana use in pregnancy: a review. Obstet Gynecol Surv. 2019;74(7):415-428. https://doi.org/10.1097/ogx.0000000000000685 - PubMed
  46. Jansson LM, Jordan CJ, Velez ML. Perinatal marijuana use and the developing child. JAMA. 2018;320(6):545-546. https://doi.org/10.1001/jama.2018.8401 - PubMed
  47. Greyson D, Roosevelt L, Boyd CJ. Desistance, self-treatment, or substitution: decisions about cannabis use during pregnancy. J Midwifery Womens Health. 2021;66(1):96-100. https://doi.org/10.1111/jmwh.13205 - PubMed
  48. Ondersma SJ, Beatty JR, Puder KS, Janisse J, Svikis DS. Feasibility and acceptability of e-screening and brief intervention and tailored text messaging for marijuana use in pregnancy. J Womens Health (Larchmt). 2019;28(9):1295-1301. https://doi.org/10.1089/jwh.2018.7169 - PubMed
  49. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. American Psychiatric Association Publishing; 2013. - PubMed
  50. Torres Ciara A., Medina-Kirchner Christopher, O'Malley Kate Y., Hart Carl L. Totality of the evidence suggests prenatal cannabis exposure does not lead to cognitive impairments: a systematic and critical review. Front Psychol. 2020;11:https://doi.org/10.3389/fpsyg.2020.00816 - PubMed

Publication Types