Mar­i­juana use up among preg­nant women de­spite doc­tors’ warn­ings

The Washington Times Weekly - - National - BY LAURA KELLY

Preg­nant women are in­creas­ingly us­ing mar­i­juana, es­pe­cially dur­ing the first trimester, even as rates of al­co­hol con­sump­tion and cig­a­rette smok­ing drop, ac­cord­ing to re­search pub­lished last week.

About 5 per­cent of women ages 18 to 44 used mar­i­juana dur­ing their preg­nancy in 2016, in­creas­ing from 2.85 per­cent in 2002. The lat­est num­bers come from an anal­y­sis by Wash­ing­ton Univer­sity School of Medicine re­searcher Ar­pana Agrawal.

The re­sults were pub­lished as a re­search let­ter in the Jour­nal of the Amer­i­can Med­i­cal As­so­ci­a­tion Pe­di­atrics and is based on fed­eral data from the Na­tional Sur­vey of Drug Use and Health.

“Un­like al­co­hol and cig­a­rette use, pre­na­tal cannabis use has not de­creased, es­pe­cially dur­ing the first trimester of preg­nancy, which is a key phase of neu­ral devel­op­ment for the fe­tus,” Ms. Agrawal wrote in the re­port.

The Cen­ters for Dis­ease Con­trol and Pre­ven­tion warns that mar­i­juana use dur­ing preg­nancy can lead to low birth weight for the baby and ane­mia for the mother. The agency also high­lights re­search show­ing that chil­dren born to women who used mar­i­juana have a harder time pay­ing at­ten­tion and dif­fi­culty learn­ing.

Ms. Agrawal an­a­lyzed sur­vey an­swers from more than 12,000 preg­nant women, most re­port­ing their drug and al­co­hol use dur­ing their first trimester.

Of those, cig­a­rette smok­ing fell from 17.5 per­cent in 2002 to 10.34 per­cent in 2016. Like­wise, drink­ing al­co­hol dur­ing preg­nancy de­creased from 9.59 per­cent to 8.43 per­cent.

Ms. Agrawal noted that the de­crease in al­co­hol use dur­ing preg­nancy was most notable for women ages 18 to 25. De­creases in cig­a­rette smok­ing were most preva­lent in white women, those ages 18 to 25 and those with a high school de­gree or higher ed­u­ca­tion.

On the other hand, women us­ing mar­i­juana dur­ing preg­nancy were more likely to be high school grad­u­ates.

Med­i­cal mar­i­juana is avail­able in 30 states and the Dis­trict of Columbia, and recre­ational sales and use are al­lowed in nine states and the Dis­trict.

The in­creas­ing num­ber of states le­gal­iz­ing mar­i­juana has led to a shift in per­cep­tion and an in­crease in use, ac­cord­ing to an over­view pub­lished in the jour­nal of Neu­ropsy­chophar­ma­col­ogy in Jan­uary.

Mar­i­juana use among adults is more preva­lent in states where cannabis is le­gal and where more peo­ple, es­pe­cially youths, view the drug as harm­less, the re­port said.

Yet the lead­ing mo­ti­va­tions for ex­pec­tant moth­ers is not clear.

The Jan­uary re­port found no no­tice­able change in mar­i­juana use among preg­nant women in states where cannabis is le­gal ver­sus those where it’s not.

In Au­gust, the Kaiser Per­ma­nente Med­i­cal Group pub­lished re­search on more than 220,000 preg­nant women in Cal­i­for­nia and found that those who used mar­i­juana re­ported self-med­i­cat­ing against se­vere symp­toms of nau­sea and vom­it­ing.

“Our find­ings add im­por­tant ev­i­dence to a small but grow­ing body of re­search sug­gest­ing that some preg­nant women may use mar­i­juana to self-med­i­cate morn­ing sick­ness,” Kelly Young, lead author of the study, said in a state­ment at the time.

De­spite the CDC’s warn­ings, re­searchers are skep­ti­cal of the re­li­a­bil­ity of longterm data. The Amer­i­can Academy of Pe­di­atrics said in an Au­gust pol­icy pa­per that the use of cannabis dur­ing preg­nancy is more likely to oc­cur along­side other il­licit drug use and cig­a­rette smok­ing, which doesn’t al­low sci­en­tists to draw in­de­pen­dent con­clu­sions about the as­so­ci­a­tion of mar­i­juana on health.

Still, the academy rec­om­mends erring on the side of cau­tion and says a num­ber of fac­tors sup­port the rec­om­men­da­tion against us­ing mar­i­juana dur­ing preg­nancy.

That in­cludes the in­creas­ing po­tency of cannabis prod­ucts and its un­known ef­fects. The po­tency of mar­i­juana in­creased by 10 per­cent­age points from 1983 to 2008, ac­cord­ing to the Au­gust re­port, es­pe­cially in states where mar­i­juana is le­gal.

Lit­tle over­sight in the cul­ti­va­tion and pro­duc­tion of mar­i­juana ex­poses the user to ingest­ing pes­ti­cides, her­bi­cides, ro­den­ti­cides, fer­til­iz­ers and other tox­ins, and the mother could pass them on to the new­born, the pe­di­atrics academy warned.

“The fact that mar­i­juana is le­gal in many states may give the im­pres­sion the drug is harm­less dur­ing preg­nancy, es­pe­cially with sto­ries swirling on so­cial me­dia about us­ing it for nau­sea with morn­ing sick­ness,” Dr. Sh­eryl A. Ryan, lead author of the academy rec­om­men­da­tion, said at the time.

“But in fact, this is still a big ques­tion. We do not have good safety data on pre­na­tal ex­po­sure to mar­i­juana. Based on the lim­ited data that does ex­ist, as pe­di­a­tri­cians, we be­lieve there is cause to be con­cerned about how the drug will im­pact the long-term devel­op­ment of chil­dren.”

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