Marijuana Use in Pregancy

Health Effects
Botanical marijuana, Cannabis sativa, contains over 60 pharmacologically active cannabinoids.[4] Both tetrahydrocannabinol (THC), the main psychoactive ingredient, and cannabidiol (CBD) may help nausea; and CBD may help some types of pain and spasticity.[4,5,6,7] After inhalation, THC concentrations rise rapidly in the blood stream, and even a single inhalation of a low-dose marijuana cigarette (16 mg THC) produces measurable levels of THC.[7,8] THC is highly lipophilic, so chronic smokers have significantly higher levels of THC after smoking as compared with infrequent users given the extended excretion from fatty tissue.[7,9] Because marijuana clears slowly from both maternal and fetal fat, fetal exposure to THC continues even after a mom stops using it.[7] Cannabinoids readily cross the placenta, entering the fetal circulation and brain, and higher fetal levels are seen with chronic use.[7,8,9,10,11,12]
Another concern is that doses of THC in marijuana have increased dramatically, from 4% in 1995 to 12% in 2014, with labs in Colorado reporting THC concentrations in some strains as high as 30%.[13] Women choosing to use marijuana in pregnancy will be exposed to significantly higher doses compared with 20 years ago.[5,13] And many strains that claim to be high in CBD in fact contain little, if any.[13] While women may think that marijuana concentrates and edibles are healthier because they do not involve smoking, they can still have significant and potentially harmful solvent residue from processing with chemicals such as butane.[13]
The endocannabinoid system is complex and not fully understood. In pregnancy it is involved from fertilization to implantation and placentation as well as in parturition.[7,14] In vitro studies with cannabinoid exposure indicted disruption of cellular messaging, angiogenesis, premature cellular death, and decreased folic acid uptake by cells.[5,14]
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