[Blunt_69]

6. Cannabis use in human pregnancy

Cannabis is the most commonly used illicit drug among women of reproductive age and in the United States the self-reported use of this substance is 2.9% during pregnancy (National Pregnancy and Health Survey, 1996 and Ebrahim and Gfroerer, 2003).

Fried (2002) has reviewed the studies on behavioral teratologic consequences of prenatal exposure to cannabis. Only two longitudinal cohorts with very different sample characteristics were found that examined the possible impact of cannabis exposure in utero on neurobehavioral and cognitive outcomes in offspring beyond early school age. The Ottawa Prenatal Prospective Study (OPPS; Fried, 2002) examines the consequences of cannabis (and smoking) use during pregnancy in a sample of low-risk, white, predominantly middle-class families, as yet up to the age of 18–22 years. The Maternal Health Practices and Child Development Study (MHPCD; Richardson and Day, 1998) has been following a high-risk cohort of low socioeconomic status, started in 1982, and has reported offspring outcome up to the age of 10. These cohorts have mainly described the impact of heavy cannabis use on offspring outcome. At present there are no studies that have focused on moderate cannabis use during pregnancy.

6.1. Neurobehavioral outcomes after prenatal cannabis exposure

In the neonatal period, findings from the OPPS and MHPCD showed that there may be an association between aspects of nervous system functioning and prenatal exposure to marijuana, reflected by increased tremors that were typically accompanied by exaggerated and prolonged startles (Fried and Makin, 1987) or altered sleep patterns (Richardson et al., 1989). The Maternal Life Style study, a clinical prospective study of acute neonatal events and long-term health and developmental outcomes associated with prenatal cocaine exposure, also included prenatal marijuana exposure. More stress/abstinence signs were found in 1-month-old infants of mothers who used low to moderate amounts of cannabis in pregnancy (Lester et al., 2002).

At the 6-year-follow up, the OPPS reported more impulsive and hyperactive behavior of children prenatally exposed to cannabis (Fried et al., 1992b). The MHPCD cohort showed that at 6 years of age, prenatally cannabis exposed children were rated by their teachers as showing more delinquent behavior (Leech et al., 1999). Moreover, the 6-year-old children showed more impulsive behavior at a continuous performance task (Leech et al., 1999). At age 10, these children had hyperactivity, increased inattention, impulsivity and delinquency symptoms as reported by their mother and their teachers (Goldschmidt et al., 2000). Also, attention deficits were found, which may mediate the relation between prenatal cannabis exposure and delinquency (Goldschmidt et al., 2000).

None of these studies have focused on substance (ab)use by the offspring after prenatal exposure to cannabis.

6.2. Cognitive function after prenatal cannabis exposure

In the OPPS, no association was found between prenatal cannabis exposure and infant mental or motor development at 1 year of age (Fried and Watkinson, 1988). The high-risk MHPCD cohort, however, showed an association between the use of 1 or more joints per day in third trimester pregnancy and a decrease in mental scores of the Bayley Scales of Infant Development (Bayley, 1969) at 9 months of age, which disappeared at 18 months (Richardson et al., 1995).

When the offspring of OPPS reached the age of 4, associations between regular (more than 5 joints a week) prenatal cannabis exposure and significantly lower scores on several verbal and memory subscales of the McCarthy Scales of Children's Ability were noted (Fried and Watkinson, 1990 and McCarthy, 1972). Similar findings applied to the offspring of the MHPCD cohort at 3 years of age, in which an impairment on short-term memory, verbal and abstract/visual reasoning was found after in utero exposure to cannabis (Day et al., 1994).

As the children get older, the most striking finding is that ‘executive function’ (EF), an overarching cognitive domain reflecting the ability to organize and integrate specific cognitive and output processes over an interval of time, may be hampered. EF is involved in, e.g. cognitive flexibility in problem solving, sustained and focused attention, and working memory. Specific tests from the WISC-II, such as the Block Design and Picture Completion, requiring higher order cognitive processes which are part of EF, were performed less well by prenatal cannabis exposed 9- and 12-year-olds from the OPPS cohort (Fried et al., 1998). This is consistent with findings from the MHPCD cohort, that showed problems in abstract and visual reasoning, and more inattention and impulsivity, at 10 years of age after prenatal cannabis exposure (Richardson and Day, 1997 and Richardson et al., 2002). Fried and Watkinson (2000) examined visuoperceptual functioning in greater detail in the 9–12-year-old OPPS subjects and found more support for impaired aspects of EF (e.g. visual-motor integration, non-verbal concept formation, and inhibition of prepotent responses) after prenatal cannabis exposure. At 13–16 years of age, however, prenatal cannabis exposure was not associated with aspects of attention, such as flexibility, encoding and focusing (Fried et al., 2003).

6.3. Cannabis effects in animal pregnancy

Navarro et al. (1995) have reviewed behavioral consequences of maternal exposure to cannabinoids in rat models and concluded that it resulted in alteration in the pattern of ontogeny of spontaneous locomotor and exploratory behavior in the offspring. Adult animals exposed during gestational and early neonatal periods, when lactation took place, showed persistent alterations in the behavioral response to novelty, social interactions, sexual orientation and sexual behavior. They also exhibited a lack of habituation and reactivity to a variety of stimuli. Also, visual developmental milestones were delayed in rodents after prenatal exposure to cannabis (Borgen et al., 1973 and Fried, 1976). In addition, Mereu et al. (2003) found a disruption of memory retention and hyperactive behavior in offspring of rats who were administered with a cannabinoid receptor agonist during pregnancy. Moreover, the offspring appeared to be sensitized to reinforcing effects of morphine, suggesting an increased sensitivity to addictive behavior.

6.4. Mechanisms related to prenatal cannabis use and offspring outcomes

Cannabinoids, the psychoactive ingredients of cannabis, can cross the placental barrier (Gomez et al., 2003). This way, cannabinoids are able to affect the expression of key genes for neural development leading to neurotransmitter and behavioral disturbances (Gomez et al., 2003). Furthermore, the early presence of cannabinoid receptors during fetal brain development provides a mechanism by which cannabinoids might produce the effects found in the offspring (Navarro et al., 1995). Animal research indicates that endogenous cannabinoids and their cannabinoid CB1 and CB2 receptors are involved in embryonal implantation, neural development, and the initiation of suckling in the newborn (Fride, 2004). Also, cannabinoid CB1 receptors have been found in the human placenta (Park et al., 2003), and may mediate adverse actions of prenatal cannabis exposure. One of the major cannabinoid receptor sites in the human brain is in that part of the forebrain that is associated with higher cognitive functions (Glass et al., 1997 N. Glass, M. Dragunow and R.L.M. Faull, Cannabinoid receptors in the human brain: a detailed anatomical and quantitative autoradiographic study in the fetal, neonatal, and adult human brain, Neuroscience 77 (1997), pp. 299–318.Glass et al., 1997) as well as in the cerebellum. This may support the suggestions that prenatal cannabis exposure is related to deficits in specific higher order cognitive functions. In line with this theory are findings from a recent study on the OPPS offspring aged 18–22-years-old, using fMRI to test prefrontal cortex activity by using Go/No–Go paradigms to assess response inhibition (Smith et al., 2004). An increased activity in the left orbital frontal gyrus and right dorsolateral of the prefrontal cortex was found. The authors suggested that this result might reflect increased effort to perform the response inhibition task, which may be caused by a delayed development of this brain area. However, more studies are needed.

Other mechanisms that have been proposed originate from animal models. For instance, prenatal cannabinoid exposure influences gene expression on a key protein for brain development, the neural adhesion molecule L1, which plays an important role in processes of cell proliferation and migration, and synaptogenesis (Gomez et al., 2003). Furthermore, prenatal cannabinoid exposure altered the normal development of nigrostriatal and mesolimbic dopaminergic neurons (Rodriguez de Fonseca et al., 1991). These mechanisms may underlie the associations between prenatal exposure to cannabis and neurobehavioral and cognitive outcomes.

With regard to the HPA-axis, Del Acro et al. (2000) observed long-lasting changes in the HPA axis reactivity in rat offspring exposed in utero to a synthetic cannabinoid compound. Offspring prenatally exposed to high levels of a synthetic cannabinoid compound showed a decreased responsiveness of the HPA axis to stressors at adult ages, whereas offspring prenatally exposed to low levels of the same cannabinoid compound showed a sensitization of the HPA axis. The latter may underlie some of the behavioral changes found in the moderately exposed offspring.

Source: Neuroscience & Biobehavioral Reviews
Volume 30, Issue 1, 2006, Pages 24-41

Unfortunatly This report looks alot like all the other propagana misinformation, that say marjuanna will lead to harder drugs, that MJ is bad bad bad for you....blah blah blah.... When stuff like this looks way official it's usally is a bunch of BS..

There are recent studies that have been done, I know in canada, some actually have been prescibed MJ as a morning sickness control method, by doctors. so that lil report up there means jack to me.

Some people will be very closed minded on this subject, and rightfully so. Passing Judgement on people is wrong. There is ALOT of misinformation out there, you need to be able to spot the crap vs real world reports.

[Vorsprung]

Originally Posted by Pirate

The elimination of as many toxins as possible will only help the infant.(and mother)

Pretty amazing that some on here are actually suggesting that a mother do drugs while pregnant and call it beneficial. WOW !!

No wonder the world is so screwed up.
.
.

What you call drugs, others call homeopathic nutraceuticals. What about the 'drugs' in an epidural? What about the PERCOCET my wife was prescribed as a pain killer immediately after child birth (which she didn't take)??

Pretty amazing that DOCTORS are suggesting a mother DO DRUGS while pregnant and breast feeding, and call it beneficial.

(p.s... my 'mocking' is not meant to be personal at all.. just flipping the script, if you know what i mean man...)

a long term study was done in Jamaica, with cannabis and pregnancy. mothers studied were of varying backgrounds and smoked anywhere from no to several grams of cannabis every day (10+ joints per day). the children of the mothers who never smoked and the mothers who smoked had no differences in their mental and physical development, even years later down the road when the children became adults

its total crap - to assume marijuana is bad for pregnant woman

its based on that thought in the back of your head that says what if it is bad...

if you honestly think its harmful for people, then you shouldn't be smoking it either


btw a video of the research findings is easy to find; google: Marijuana Cannabis Use In Pregnancy Dr. Dreher

[trouble]

Originally Posted by alpinestar

a long term study was done in Jamaica, with cannabis and pregnancy. mothers studied were of varying backgrounds and smoked anywhere from no to several grams of cannabis every day (10+ joints per day). the children of the mothers who never smoked and the mothers who smoked had no differences in their mental and physical development, even years later down the road when the children became adults

its total crap - to assume marijuana is bad for pregnant woman

its based on that thought in the back of your head that says what if it is bad...

if you honestly think its harmful for people, then you shouldn't be smoking it either


btw a video of the research findings is easy to find; google: Marijuana Cannabis Use In Pregnancy Dr. Dreher

Dr. Melanie Dreher who conducted the study your referring to is a "Anthropologist". LOL!

She is not a Medical Doctor, she has a ph.D in Anthropology!

If one of your children had cancer would you take he/she to an Antropologist to treat the disease? Someone that studies the origin, cultural, and social behavior of people?

Or would you seek help from an MD (Medical Doctor) who is accomplished in the science of medicine and it's applied practice through a detailed knowledge of anatomy, physiology, diseases, and treatment?

Taking medical advice from an "Anthropologist" who has a ph.D and calls herself a Doctor, is like going to a "Television Evangelist Preacher" with a ph.D in Biblical studies and calls himself a Doctor for cardiovascular surgery. LOL!





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[ROJO145]

Good Eye Trouble!!!The trouble with the internet is ya can fnd any study ya want,right or wrong,but I see ya still cant find common sense!!!Are people really thinking its ok to smoke anything while pregnant,I mean trying to find studies that support that!!Sad fuckers!!
A noted anthropologist says its ok to smoke while pregnant,her jamaican studies have shown so!!!!!!!!!!!!!!!!!!!!!!!!!!!! !!!!!!!!!TOO MUCH!!!

Originally Posted by trouble

Dr. Melanie Dreher who conducted the study your referring to is a "Anthropologist". LOL!

She is not a Medical Doctor, she has a ph.D in Anthropology!

If one of your children had cancer would you take he/she to an Antropologist to treat the disease? Someone that studies the origin, cultural, and social behavior of people?

Or would you seek help from an MD (Medical Doctor) who is accomplished in the science of medicine and it's applied practice through a detailed knowledge of anatomy, physiology, diseases, and treatment?

Taking medical advice from an "Anthropologist" who has a ph.D and calls herself a Doctor, is like going to a "Television Evangelist Preacher" with a ph.D in Biblical studies and calls himself a Doctor for cardiovascular surgery. LOL!





.......

I had a whole response to what you wrote, then I though good god this is long and might be confusing so I'm just going to say this:

I understand what you're saying but you're being too damn general. Dreher's study is no less scientific than any other you read about on a daily basis.

The only studies showing negative outcomes from cannabis use and pregnancy were funded by the same people who tell you weed will destroy your life

I respect your opinion but at the same time in my mind you are incorrect

[Mrs. Swamp]

I believe it is a woman's choice if she wants to smoke weed or not while pregnant ....everyone is entitled to their opinion. Like I said before, I smoked with both of my children, and they are very happy and healthy and intelligent.

[nag-champa]

i skipped much of the thread, sorry if this was already discussed.

do woman take prescriptions generally while pregnant?
how about the pain killer they get upon delivery?
would not that be worse than cannabis?
and if your going to do it vaporize it for fuck sake, its supposed to remove carcinogens

[Bobby Stainless]

how about the pain killer they get upon delivery?

You can get a epidural. However,no pain killers are given. The difference with the pain medication that is given at the hospital, is that is does not cross through the placenta, where THC can.

Thanks for all the great responses. I do not agree with the girl's choice, but that is the beauty of being able to choose.

[HawaiianPunch]

Excuse me, trouble, but a doctorate only distinguishes a degree of learning at an official institution. My mama don't got no doctorate but I'll trust her over most doctors out there, thank you very much. This Anthropologist spent a lot of time investigating the effects of marijuana on pregnancy. She made her conclusions public. There are some "real" doctors who "accidently" cut off the wrong leg, or leave behind their scalpels during surgery. Their are some "real" doctors who cheated, lied, and paid their ways through med school because daddy was a doctor too. TRUST me, docotors don't know beans froom balogna most of the time. They just wanna sign off your health to insurance and pharmecuetical companies who pay their mortgages and car notes. YOU mean nothing. You are just $$$