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Not your mother's weed...

December 15, 2015
It's legal in Colorado. Why would marijuana harm your unborn baby?

The major active compound in all cannabis products is Δ9-tetrahydrocannabinol (Δ9-THC), or simply THC. Research has established that THC can rapidly cross the placenta barrier, resulting in fetal plasma concentrations of THC equivalent or even higher than the maternal concentrations (Alhabri & el-Guebaly, 2014). People usually report feelings of euphoria, detachment and relaxation after marijuana use. However, if taken in large doses, acute marijuana intoxication can result, with symptoms ranging from euphoria, tachycardia and anxiety to paranoia, depersonalization, confusion, feelings of panic and even hallucinations (Johns, 2014).

Cannabis also has a biphasic effect on the autonomic nervous system and, when taken in low doses, increases sympathetic nervous system activity and decreases parasympathetic activity, resulting in tachycardia and increased cardiac output (Brown & Graves, 2013). At higher doses, cardiac activity is affected in reverse, resulting in hypotension and bradycardia (Brown & Graves, 2013). Unfortunately, your baby does not appreciate such an unstable environment.

The amount of THC can vary tremendously from plant to plant or even on different parts of the same plant; therefore, there's no way to verify the amount of THC a person consumes each time they use cannabis (Alharbi & el-Guebaly, 2014). Depending on the plant strain and production site, the actual mean of THC content of cannabis can range anywhere from 3 percent to 17 percent (Calvigioni et al., 2014). Warner, Roussos-Ross, and Behnke (2014) report that from the 1970s to 2000s there has been a six- to sevenfold increase in the potency of THC from cannabis seized in the United States.

The legalization of marijuana can create even greater challenges due to the increased consumption of synthetic cannabinoids, known commonly by the street name “Spice.” Synthetic cannabinoids contain potent THC analogues that are 500 to 600 times more potent than the THC found in “traditional” marijuana and are not regulated by the FDA. Use of Spice can result in severe side effects as compared to those resulting from simple cannabis. Adverse maternal effects include heart palpitations, tachycardia and even seizures (Psychoyos & Vinod, 2012). Spice will not show on a standard urine drug screen as positive, which is one reason it's a preferred choice among younger people and is sometimes referred to as a “legal high” (Schneir, Cullen, & Ly, 2011). It can easily mimic or be mistaken for pre-eclampsia or eclampsia because of the adverse side effects of seizures and negative urine drug screens (American College of Obstetricians and Gynecologists [ACOG], 2013).

Fetal Concerns
Cannabis is lipophilic in nature, so there is concern that it crosses many types of cell membranes, including the placenta and blood-brain barrier. Fetal development studies in mice suggest that THC can affect parts of the brain and neural development including the amygdala in the limbic system and prefrontal cortex, resulting in negative long-term emotional, cognitive, and behavioral consequences. The effect of THC may alter certain receptors in the brain during fetal development, leading to problems with attention, memory and problem solving (National Institute on Drug Abuse, 2014).

Increasing evidence has shown THC in both synthetic and traditional form can be harmful to embryonic development as early as 2 weeks after conception and can affect brain development before signs of pregnancy are present (Psychosos & Vinod, 2012). Animal studies on exogenous cannabinoid (THC) exposure has been linked to increased risk of anencephaly as early as 1 to 4 weeks gestation; impairments in neural circuitry affect cognitive and emotional brain centers with exposure at 18 to 22 weeks (Psychosos & Vinod, 2012).

Studies following infants with exposure to marijuana during pregnancy have found lower birth weight, decreased height, decreased gestational periods and increased risk for preterm labor (Alharbi & el-Guebaly, 2014). Marijuana users were also found to have dysfunctional labor, precipitous labor and meconium-stained amniotic fluid (Alharbi & el-Guebaly, 2014).

Although research is limited regarding the effects of marijuana on fetal development, it has been established that there are potential long-term consequences from prenatal exposure, including behavioral and cognitive implications. This includes lower verbal reasoning scores, impaired mental development, hyperactivity, inattention, impulsivity and impairment in executive function (planning, organizing, prioritizing) and memory (Calvigioni et al., 2014). One study found that exposure during the first trimester was linked to deficits in reading and spelling scores and lower child performance at age 10. Moreover, marijuana use in the second trimester of pregnancy was associated with lower reading comprehension and overall underachievement among offspring (Calvigioni et al., 2014).

Research and statistics from Nursing for Women's Health journal article:
read full article and resources here

Talk to your medical careprovider about the use of Marijuana during pregnancy and breastfeeding.  There may be alternative therapies to replace your use of Marijuana, that are much safer for your baby.

Heather Knott, RN-IBCLC
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