Pregnancy, breast-feeding, and marijuana: A review article

Marijuana is a commonly used drug. At present, it remains an illegal substance in most areas of the United States. Recent controversy regarding the perceived harms of this drug has resulted in debate in both legal and medical circles. : This review examines evidence regarding the effects of marijuana exposure during pregnancy and breast-feeding. We examined studies pertaining to fetal growth, pregnancy outcomes, neonatal findings, and continued development of fetuses and neonates exposed to marijuana through adolescence. In addition, the legal implications for women using marijuana in pregnancy are discussed with recommendations for the care of these patients. : The current evidence suggests subtle effects of heavy marijuana use on developmental outcomes of children. However, these effects are not sufficient to warrant concerns above those associated with tobacco use. : Marijuana is the most commonly used illicit substance in the United States. It is predominantly used for its pleasurable physical and psychotropic effects. With the recent changes to legislature in Colorado and Washington State making the recreational use of marijuana legal, marijuana has gained national attention. This raises the question: If it is legal for a woman to consume marijuana, what is the safety of this activity in pregnancy and breast-feeding? Moreover, do the harms of marijuana use on the fetus or infant justify the mandatory reporting laws in some states? TARGET AUDIENCE: Obstetricians and gynecologists, family physicians LEARNING OBJECTIVES: After completing this CME activity, physicians should be better able to assess the prevalence of marijuana use in the general obstetric population, evaluate the fetal, neonatal and childhood outcomes associated with marijuana use during pregnancy and breastfeeding, and care for pregnant women who are faced with the possible legal implications of screening for drug use.