The overwhelming advice of researchers in this field is that the safest course of
action is to avoid cannabis exposure in utero, and to the developing infant, yet women
and cannabis dispensers are likely to believe it is safe. There is a very real risk
that legalization may be equated with safe in the minds of the public. In legalizing
cannabis, which comes from a plant containing hundreds of active chemicals, the government
needs to
- 1Take immediate steps to ensure that the message regarding safety in pregnancy is clear and unambiguous.
- 2Recognize that we are in the unique position to address the enormous gap in research in the neurodevelopmental safety of these substances and should commit to supporting this research.
- 3Provide mechanisms to support clinical and population heath research, including long-term follow-up.
- 4Provide guidance on regulation to ensure that false health claims are not made regarding cannabis in pregnancy.
- 5Support the development of clinical practice guidelines and evidence-based educational initiatives for cannabis dispensaries, health providers, and pharmacists, as well as knowledge dissemination.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Obstetrics and Gynaecology CanadaAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings.Substance Abuse and Mental Health Services Administration, Rockville, MD2014 (Report No.: NSDUH Series H-48, HHS, Publication No. (SMA) 14-4863 [Internet]. Available at:) (Accessed on June 21, 2018)
- Substance misuse in early pregnancy and relationship to fetal outcome.Eur J Pediatr. 1999; 158: 488-492
- Alternative biological materials to detect prenatal exposure to drugs of abuse in the third trimester of pregnancy.An Pediatr (Barc). 2012; 77: 323-328
- Pregnancy-related substance use in the united states during 1996-1998.Obstet Gynecol. 2003; 101: 374-379
- Substance abuse in Canada. Licit and illicit drug use during pregnancy: maternal, neonatal and early childhood consequences.Canadian Centre on Substance Abuse, Ottawa2013 (Available at:) (Accessed on June 21, 2018)
- Marijuana, the endocannabinoid system and the female reproductive system.Yale J Biol Med. 2016; 89: 175-191
- Comorbidity between DSM-IV alcohol and specific drug use disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions.Drug Alcohol Depend. 2005; 80: 105-116
- The changing gender gap in substance use disorder: a total population-based study of psychiatric in-patients.Addiction. 2012; 107: 1957-1962
- Evidence for a closing gender gap in alcohol use, abuse, and dependence in the United States population.Drug Alcohol Depend. 2008; 93: 21-29
- Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States: results from the national epidemiologic survey on alcohol and related conditions.Arch Gen Psychiatry. 2007; 64: 566-576
- Substance Use During Pregnancy.F1000Research Ltd., London2016 (Available at:) (Accessed on June 21, 2018)
- A review of recent findings on substance abuse treatment for pregnant women.J Subst Abuse Treat. 1999; 16: 195-219
- Substance misuse in pregnancy.in: Powrie MF Greene MF Camann W de Swiet's medical disorders in obstetric practice. Wiley-Blackwell, West Sussex, UK2010: 477-504
- Epidemiology of drug and alcohol use in young women.Semin Fetal Neonatal Med. 2007; 12: 98-105
- Models of care for substance misuse treatment.UDH Publications, London2002
- Data spotlight: substance use during pregnancy varies by race and ethnicity.Substance Abuse and Mental Health Services Administration, Rockville, MD2012
- Substance use in the perinatal period.Curr Psychiatry Rep. 2015; 17: 91
- Canadian Tobacco Alcohol and Drugs (CTADS): 2015 Summary.Health Canada, Ottawa2017 (Available at:) (Accessed on June 21, 2018)
- Prenatal marijuana and alcohol exposure and academic achievement at age 10.Neurotoxicol Teratol. 2004; 26: 521-532
- Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age.Am J Obstet Gynecol. 2015; 213 (201.e1–10)
- The 4P's Plus screen for substance use in pregnancy: clinical application and outcomes.J Perinatol. 2005; 25: 368-374
- 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: 211-216
- Recommendations from cannabis dispensaries about first-trimester cannabis use.Obstet Gynecol. 2018; 131: 1031-1038
- Maternal marijuana use and adverse neonatal outcomes: a systematic review and meta-analysis.Obstet Gynecol. 2016; 128: 713-723
- Prenatal exposure to cannabis and maternal and child health outcomes: a systematic review and meta-analysis.BMJ Open. 2016; 6e009986
- 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
- Data from three prospective longitudinal human cohorts of prenatal marijuana exposure and offspring outcomes from the fetal period through young adulthood.Data Brief. 2016; 9: 753-757
- At the tip of an iceberg: prenatal marijuana and its possible relation to neuropsychiatric outcome in the offspring.Biol Psychiatry. 2016; 79: e33-e45
- Clearing the Smoke on Cannabis: Maternal Cannabis Use During Pregnancy – An Update.Canadian Centre on Substance Abuse, Ottawa2015 (Available at:) (Accessed on June 21, 2018)
- The effects of prenatal marijuana exposure on delinquent behaviors are mediated by measures of neurocognitive functioning.Neurotoxicol Teratol. 2011; 33: 129-136
- Effects of prenatal marijuana exposure on child behavior problems at age 10.Neurotoxicol Teratol. 2000; 22: 325-336
- Differential effects of cognitive functioning in 13- to 16-year-olds prenatally exposed to cigarettes and marijuana.Neurotoxicol Teratol. 2013; 25: 427-436
- Prenatal marijuana exposure contributes to the prediction of marijuana use at age 14.Addiction. 2006; 101: 1313-1322
- Effects of prenatal cigarette and marijuana exposure on drug use among offspring.Neurotoxicol Teratol. 2005; 27: 267-277
- Prenatal exposure predicts marijuana use in young adulthood.Neurotoxicol Teratol. 2015; 47: 10-15
- Cannabis use during pregnancy: pharmacokinetics and effects on child development.Pharmacol Ther. 2018; 182: 133-151
Article info
Footnotes
Competing interests: The authors declare that they have no competing interests.
Identification
Copyright
© 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Letter: Cannabis: Implications for Pregnancy, Fetal Development, and Longer-Term Health OutcomesJournal of Obstetrics and Gynaecology Canada Vol. 41Issue 2
- PreviewI am writing in response to an article published in the Journal in September, titled “Cannabis: Implications for Pregnancy, Fetal Development, and Longer-Term Health Outcomes,” by Cook and Blake.1 Given the relevance of cannabis research in our current era of legalization and the trend toward increasing usage and public acceptance, studies on cannabis use are extremely important and thus must be held to high standards, especially when pregnant women and children are the population of interest.
- Full-Text
- Preview
- Author Response: Cannabis: Implications for Pregnancy, Fetal Development and Longer Term Health OutcomesJournal of Obstetrics and Gynaecology Canada Vol. 41Issue 2
- PreviewWe are writing to reply to the response to our article published in the Journal in September, titled “Cannabis: Implications for Pregnancy, Fetal Development, and Longer-Term Health Outcomes,” in which the writer suggests that we misrepresented findings, selectively reported findings, and omitted relevant articles.
- Full-Text
- Preview