Clinical report provides guidance on marijuana use in pregnancy and lactation

1. The American Academy of Pediatrics (AAP) published a clinical report that examines the established and emerging data surrounding marijuana use in pregnancy, and provided guidelines for clinicians based on current consensus.

2. The report highlights concerns about marijuana use in pregnancy and lactation due to potential for adverse short and long-term outcomes in offspring. These outcomes may include increased fetal mortality and changes in executive behavioral regulation in young adults.

3. The report also surveys basic science evidence to provide potential mechanisms for observed findings, including citing clear evidence that marijuana metabolites cross the placenta and are also found in breast milk.

Report Rundown: Marijuana is one of the most frequently used substances during pregnancy (~5% in the United States), though understanding of its public health and individual health effects has been relatively limited. With the ongoing trend of marijuana legalization, concerns about marijuana use in pregnancy and lactation have continued. Led by the Committee on Substance Use and Prevention, the AAP published a report that surveys the epidemiology and pharmacology and presents clinical guidance on marijuana use in pregnancy and lactation. Broadly, the report claims that marijuana use in pregnancy is estimated around 4-9%, and there has been an increase in the use of marijuana to self-treat nausea in pregnancy. The report goes on to review limited and conflicting evidence about offspring outcomes in infants, children, and adolescents, noting the relative dearth of specific research that addresses outcomes after specific marijuana use in pregnancy. Next, the report describes current understandings of the role of the endocannabinoid system (on which marijuana acts) in development, and in psychiatric illness, noting again a need for further research. Finally, the report examines breastfeeding and marijuana use, citing studies that show the presence of marijuana metabolites in breast milk. Overall, the Clinical Report assesses the current state of knowledge and provides justified clinical recommendations that include recommending abstinence from marijuana in pregnancy and lactation due to both lack of safety evidence and strong theoretical justification for adverse outcomes for offspring.

Click to read the Clinical Report, published today in Pediatrics

Relevant Reading: Marijuana use in pregnancy and lactation: a review of the evidence

Image: PD

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