Between four and five percent of pregnant people report some level of cannabis use. This level decreases markedly throughout pregnancy. Many who report using cannabis during pregnancy do so to address symptoms of nausea/morning sickness.
RESOURCES: Cannabis and pregnancy: Maternal child health implications during a period of drug policy liberalization, Preventive Medicine, 2017 | Marijuana use in pregnancy and lactation: A review of the evidence, American Journal of Gynecology & Obstetrics & Gynecology, 2015 | Survey of medicinal cannabis use among childbearing women: patterns of its use in pregnancy and retroactive self-assessment of its efficacy against ‘morning sickness’, Complementary Therapies In Clinical Practice, 2006
Data to date is inconsistent with respect to whether in utero cannabis exposure is independently associated with low birthweight, pre-term birth, or other adverse neonatal outcomes (e.g., shorter gestational age)
“The aim of this study is to estimate the association between marijuana use during pregnancy and total, spontaneous and indicated preterm birth. … Marijuana use was not associated with total preterm birth in this cohort, suggesting that among women already at high risk of preterm birth, marijuana does not increase risk further.”
“This is a retrospective cohort study from July 2016 to December 2018 of pregnant women who had universal drug screening of marijuana use before and after legalization of recreational marijuana in California on 1 January 2018. Maternal medical conditions and neonatal outcomes associated with usage were also evaluated. … There were no differences in neonatal outcomes between users and non-users.”
“Compared with babies of mothers who had never used cannabis, infants of those who still used at 15 weeks had lower mean values for birthweight, head circumference, and gestational age at birth.”
“Marijuana exposed newborns had significantly worse birth outcomes than controls, weighing less … and more likely to be low birth weight, preterm, or admitted to the NICU.”
“A study was carried out in 4465 infants whose mothers delivered during 2017 and 2018. Self-reported maternal smoking, e-cigarette and cannabis use at booking were recorded. Outcome measures were birthweight and head circumference z-scores and admission to the neonatal intensive care unit (NICU). … Cannabis use alone was not associated with a significant reduction in birthweight or head circumference z-score, but the combination of cannabis and cigarette smoking resulted in a significant decrease in both z-scores compared to cigarette smoking alone.”
“[O]verall prevalence of marijuana use during pregnancy was low. … [M]arijuana use during pregnancy was not independently associated with infant birth weight or gestational age, after controlling for confounding. … Further, we did not observe significant effects of marijuana use during pregnancy and preterm birth or healthcare utilization.”
“[M]aternal marijuana use during pregnancy is not an independent risk factor for low birth weight or preterm delivery after adjusting for factors such as tobacco use. There also does not appear to be an increased risk for other adverse neonatal outcomes such as SGA (small for gestational age) and placental abruption once we account for other influencing factors. … [T]he results of this systematic review and meta-analysis suggest that the increased risk for adverse neonatal outcomes reported in women using marijuana in pregnancy is likely the result of coexisting use of tobacco and other cofounding factors and not attributable to marijuana use itself.”
“After adjustment for confounding, cannabis use was not associated with mean birth weight or gestational age or with low birth weight or preterm delivery. … Reported cannabis use does not seem to be associated with low birth weight or preterm birth.”
“The infants were not significantly different in the groups (as distinguished between marijuana using mothers and mothers who did not use cannabis) according to physical exam data including birth weight and length and gestational age.”
In utero cannabis exposure is not independently associated with significant, consistent adverse effects on childhood development
RESOURCES:Breathe, Push, Puff? Pot Use and Pregnancy: A Review of the Literature, NORML, 2009 | Women and Cannabis: Medicine, Science, and Sociology, Haworth Press, 2002
“Contrary to our pre-registered hypotheses, children with prenatal cannabis exposure had higher scores on the Bayley-III Language scale, and children with prenatal exposure to cannabis and tobacco had a greater age-related increase in language scores, compared with the other groups. … In short, we found no evidence that prenatal exposure to cannabis was associated with impaired cognitive or language development, and no evidence that the combination of cannabis and tobacco was associated with worse outcomes compared with either drug alone, in this sample. … This [finding] could help to reduce the stigma experienced by women who use cannabis during pregnancy and potentially lower the barrier for seeking help in this group.”
“This study utilized a large, longitudinal dataset to examine the differential and combined effects of PAE [prenatal alcohol exposure] and PCE [prenatal cannabis exposure] on trajectories of cognitive abilities across adolescence, a critical period of cognitive development. … No effects persisted after including covariates. … Results suggest light prenatal alcohol and cannabis use are not associated with long-term negative cognitive outcomes during adolescence and highlight the importance of considering the impact of social factors when studying associations with prenatal substance use.”
“We examined the association between in utero cannabis exposure and well child care (WCC) attendance, emergency department (ED) visits, and developmental delay (DD) diagnosis during the first two years of life. … No difference in WCC or ED visits was observed between cannabis-exposed and substance-unexposed infants. There was a decrease in the odds of DD in the first 2 years among cannabis exposed infants and no difference at 3 years. CONCLUSION: Compared to those unexposed, Medicaid-insured children who were exposed to cannabis in utero have similar WCC attendance and ED use over the first 2 years and similar developmental outcomes at 3 years.”
“This study evaluated the association between PME [prenatal marijuana exposure ] and neuropsychological test scores in late childhood and early adulthood, accounting for a wide range of parental characteristics. … After adjusting for sociodemographic and clinical covariates, PME was not associated with worse neuropsychological test scores at age 10 or autistic traits at 19-20.”
“This article provides a critical review of results from longitudinal studies examining the impact of prenatal cannabis exposure on multiple domains of cognitive functioning in individuals aged 0 to 22 years. … The current evidence does not suggest that prenatal cannabis exposure alone is associated with clinically significant cognitive functioning impairments.”
“The evidence base for maternal-infant health outcomes of cannabis use in pregnancy is more robust than for many other substances. … Although there is a theoretical potential for cannabis to interfere with neurodevelopment, human data drawn from four prospective cohorts have not identified any long-term or long lasting meaningful differences between children exposed in utero to cannabis and those not.”
“Neither maternal nor paternal cannabis use was associated with educational attainment (in their children) in observational analyses, but few mothers in our sample used cannabis regularly in pregnancy.”
“This research provides data on the development of 59 Jamaican children, from birth to age 5 years, whose mothers used marijuana during pregnancy. … The results show no significant differences in developmental testing outcomes between children of marijuana-using and non-using mothers except at 30 days of age when the babies of users had more favourable scores on two clusters of the Brazelton Scales: autonomic stability and reflexes. The developmental scores at ages 4 and 5 years were significantly correlated to certain aspects of the home environment and to regularity of basic school (preschool) attendance.”
