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Is Cannabis Safe During Pregnancy

by | Apr 5, 2021 | Pregnancy | 0 comments

Pregnancy can be an especially stressful time in a person’s life. A lot of the common issues pregnant people experience would otherwise be eased by the use of cannabis, like increased anxiety levels, nausea, and appetite issues. But is it safe for the expectant parent to take cannabis products while they are pregnant? What about after the baby is born? If the new parent is experiencing heightened anxiety, depression, or pain, is it okay for them to then take cannabis?

 

The Endocannabinoid System

First, let’s discuss what makes cannabis products so effective in a wide variety of issues people may suffer from. It happens at a molecular level and within the Endocannabinoid System (ECS) of the human body. The ECS is the system in control of homeostasis within the body. It’s where the body senses and corrects any type of disturbance that happens internally. The ECS functions using three primary elements called endocannabinoids, receptors, and enzymes. 

The endocannabinoids are naturally occurring chemical compounds found within the human body. These compounds are very similar to the chemical compounds found in cannabis, otherwise known as cannabinoids. Since the two compounds are so molecularly similar, cannabinoids can easily attach themselves to endocannabinoid receptors. 

The receptors within the endocannabinoid system are found on the surface of cells throughout the body. When endocannabinoid (or cannabinoid) compounds attach themselves to the receptors, it allows them to communicate with different systems, helping the ECS maintain homeostasis. The receptors and compounds stay attached to each other until enzymes are introduced to break the connection. 

Enzymes within the ECS are introduced after the receptor and endocannabinoid have worked together to achieve the desired level of stabilization in a specific system. Once the flux in homeostasis has been corrected, the enzymes attach to the endocannabinoids and break them down. 

Because the body’s natural endocannabinoids and the cannabinoids from a cannabis plant are so similar, cannabis products like CBD and other cannabinoids have an opportunity to interact with the human body in a special way. CBD can attach itself to the ECS receptors, effectively dampening or blocking some signals they are sending, or even using itself as a barrier between the receptor and the enzyme, protecting the endocannabinoid attached to it. 

 

Cannabis and the Fetus

A recent study conducted in California found that nearly 11% of women reported using cannabis while they were pregnant. Cannabis is legal in California, and the study reports that the number of women using cannabis while pregnant increased from 6% when it was last surveyed, before legalization. It should be noted, however, that the study does not designate differences in strain or type of cannabis, including THC levels [1]. This particular study is just one of many, however like the others the information is somewhat limited as it does not include data on CBD use. It also does not include information about whether the expectant mothers are also using substances like nicotine or caffeine. Why is that aspect important? Well without that additional information it’s difficult to determine whether any conditions after birth are present due to cannabis or other factors, such as those substances. 

Overall, studies on the effects of cannabis use during pregnancy has provided inconsistent results. Much of this comes from the fact that timing of use during pregnancy may play a large part in determining what developmental effects are seen. For instance, the cannabinoid type I, or CB1, receptors that THC would normally activate to feel a certain level of intoxication is not present in the fetus until around 19 weeks.

However, in studies performed on monkeys, researchers found that THC quickly passed through the placenta and was easily detected in fetal blood within just 15 minutes of the mother ingesting marijuana [2]. The ability of the THC to pass into the fetus’ bloodstream, however, does not mean the fetus actually becomes intoxicated. In fact, it’s not until the third trimester that a fetal brain has the proper structures in place for that effect to take place, and even at that point the experience would be very different than what we know [3].

Regardless, CB1 receptors and all the rest of the endocannabinoid system still plays a huge role in brain development. These receptors are responsible for influencing how brain cells develop, where they go, which ones to connect to, how to connect, and what to look like. So if the development of these cells is interrupted by THC binding itself to the receptor, it could be disruptive and lead to issues like lower birth weight, premature labor, and higher odds of needing to be admitted to neonatal intensive care [4].  

 

Other Substances

While the research is still ongoing on what effects cannabis truly does have on a developing fetus, scientists are beginning to see that whatever effects of cannabis are present, they are heightened even further by the addition of other substances like tobacco and alcohol. One study suggests that pregnant mothers combining tobacco and cannabis would be more likely to see their baby have a difficult time with the ability to self-soothe when compared to infants from mothers who only used tobacco [5]. This particular effect is more common in baby girls, however another study concluded that cannabis combined with tobacco use led to a dysfunction in baby boys that impaired their ability to regulate their stress [6]. 

While there haven’t been studies yet, it is also possible that other medications for anxiety, nausea, and sleep that expecting mothers may be taking could also bring higher odds of developmental issues when combined with cannabis products. While there is no definitive proof yet, pregnant women should be aware of the potential risks.

 

Cannabis and Mental Development

Multiple studies have found that THC has harmful effects on brain development, which means cannabis products like marijuana should be avoided by pregnant women. Specifically, the regions of the brain associated with impulse control, executive functioning, emotional development, and reward processing are especially susceptible to damage from the THC cannabinoid if a fetus’ brain is exposed to it [7]. 

Even older children may feel the effects of cannabis if they are exposed to it while in the womb. A report found that even 10-year-old children had higher levels of depression if their mothers were heavy cannabis users during even the first trimester [8]. 

There haven’t been studies on the effects of CBD on the brain of a developing fetus, however CBD has more than 65 targets in the brain and body of a fetus and uses the endocannabinoid system to activate its results, so scientists are unsure what its long-term consequences could be. There is no clear evidence that it could harm a fetal brain, but there is also nothing proving its safety.

 

Risk Factors After Birth

Even after birth, a baby can still be affected by cannabis, either through secondhand smoke or breastmilk. One study found that THC and other metabolites were found in adults in trace amounts after being exposed to secondhand marijuana smoke. Lower trace levels such as these wouldn’t be likely to impact a child in any detrimental way, however repeated exposure to that secondhand marijuana smoke has the potential to build up over time due to the fat-soluble properties of THC and other cannabinoids [9]. 

Cannabinoids easily transfer from breast milk to an infant, with THC being detected in breast milk for up to 6 days after consumption [10]. However some studies have shown there was no transfer at all. Right now it is unclear what factors lead to the transfer of THC in only some of the cases, but it’s still best to be more cautious than not. Researchers have also found variability between the proportion of THC that gets transferred to the infant in breast milk, with the numbers ranging from as little as 0.4% to as much as 8.7% [11]. There are no obvious predictors to explain why different people fall into different ranges, but studies do estimate that infant exposure is about 1,000 times lower than the mother’s would be. It remains unclear if that is enough to damage the child’s brain development however [12]. 

While so much of the research is still ongoing and overall fairly inconclusive, one thing is for sure: there is evidence that suggests cannabis products may impact the development of a fetus, so expectant mothers should speak to the doctor and always err on the side of caution by avoiding cannabis products while they are pregnant and nursing. Cannabis products like marijuana and CBD should have a permanent place in the medicine cabinet, but during certain life events it’s safer to let them sit unused.