The group that represents obstetricians and gynecologists in Canada is watching the pending legalization of marijuana with concern, saying there is growing evidence suggesting its use by pregnant mothers negatively affects brain development in their fetuses.
“Our worry is that because it is made legal, people may think it is not a problem,” said Dr. George Carson, president of the Society of Obstetricians and Gynecologists of Canada.
“While it will be legal, the SOGC’s position is that we believe there are adverse effects on brain development from marijuana consumption until the brain development is finished, which is not until the early 20s. It is legal, but should be strongly discouraged.”
Of further concern is that marijuana is widely promoted among some as an anti-nauseant during early pregnancy.
“There are safe and more effective medications for nausea in pregnancy” said Carson. “My hope is that it is not used because of the adverse effects on brain development.”
Although more research needs to be done, a growing body of evidence points to negative effects on brain development as a result of marijuana exposure which can potentially affect the executive functions of the brain and behaviour.
The Society of Obstetricians and Gynecologists of Canada is issuing new guidelines on substance use during pregnancy later this year, partly because of the upcoming legalization of marijuana and new research into its effects, and partly because increased use of opioids.
It is also planning to conduct research to get a better sense of substance use during pregnancy, as well as during other times in women’s reproductive lifespan.
Substance use is the second leading killer of women during pregnancy, in part, because of fentanyl, said Jocelynn Cook, chief scientific officer at SOGC. A recent review of research, by Cook and others, noted the increased use of opioids among pregnant women is an emerging trend.
“This rise is purported to be a combination of the frequency of prescribed opioids for pain control in pregnant women, illicit use, and an increase in opioid-substitution programs for treatment of addiction … opioids are now being used by a more diverse population that includes pregnant women.”
“We really want to look at what women are doing now related to substance use — what is happening during pregnancy, what do women believe, what are their behaviours and where do they get their information?”
She said the research is important now because the landscape is changing when it comes to substance use.
“We know that 15 per cent of women drink alcohol during pregnancy, we don’t have the same information around cannabis use … we are scrambling to try to figure out how we can help target those populations.”
Canada has some of the highest rates of cannabis use by adolescents among developed nations. In addition, opioid use is rising rapidly. There are increasing numbers of babies born in Canada who are addicted to opioids because their mothers took them during pregnancy.
Carson, who works in Regina, said opioid use during pregnancy is of growing concern, but can also be an opportunity to improve the health of substance-using women in some cases. Women who are drug addicts tend not to be engaged with health care, he said, but will often seek medical treatment when they are pregnant.
He said getting a pregnant mother who is addicted to opioids into a methadone program can improve her health and her baby’s health.
Although there is a general increase in drug use among pregnant women, cannabis remains the most commonly used illicit substance. Estimates of women who use cannabis while pregnant have ranged from just under two per cent to more than 16 per cent, according to the research by Cook and others. It’s widespread use, the report said, “may be due in part to its reputation as a harmless drug.”
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