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CBD and Pregnancy

Jun 27, 2019
CBD and Pregnancy

CBD is considered a safe alternative to pharmaceuticals for those who seek relief from pain, depression, anxiety, stress and other ailments. But that could all change if a person is pregnant.

When you are carrying a fragile human being in your womb, everything that you come into contact with can potentially affect the fetus. Even food items that seem harmless could pose a potential risk. These include pineapples, raspberry tea, certain cheeses and fish, allergy medication, and over-the-counter drugs. Your developing baby is delicate and vulnerable so you should be very careful what you ingest.

While pregnancy can be a beautiful experience, it can come with unpleasant symptoms especially during the first trimester. Physical discomfort includes nausea, migraines, and chronic pain. Psychologically, some pregnant women face severe anxiety and even depression.

Cannabis is known to help with physical and psychological symptoms such as these. But because your unborn child is fragile, you should never consume substances with psychoactive properties.

The cannabis plant contains more than 100 cannabinoids with different effects on the body. THC is definitely a no-no when you are pregnant because it is a psychoactive substance. The non-psychoactive cannabinoid – CBD – is considered much safer than THC but is it completely safe to take to relieve the uncomfortable side effects of pregnancy?

How cannabis impacts pregnancy

How cannabis impacts pregnancy

Most investigations on the effects of cannabis on pregnancy are focused on THC and not CBD. Conclusive data to determine the effects of CBD on a fetus has been severely lacking.

Here is what we know: the little human in your tummy already has its own endocannabinoid system even when the fetus is only composed of two cells. The endocannabinoid system is a network of neurotransmitters that play an important role in the brain development of your baby.

Introducing cannabis – specifically marijuana – to your body can interfere with this development and pose great harm to your baby. This is why you should not smoke pot when you are pregnant. THC can interrupt the natural development process and cause birth defects related to the nervous system.

In a study conducted on mice, researchers found that THC inhibited development in embryos that contain less than eight cells. Anandamide – a natural cannabinoid found in the body – also stopped the embryos from developing. Because CBD is known to increase levels of anandamide, there may be negative effects on pregnancy. Do note that the study was conducted on rat models and may not necessarily have the same results on human subjects.

In a 2014 study, meta-analysis demonstrated that women who took cannabis during pregnancy were more at risk for anaemia. Infants exposed to cannabis in utero also had a decrease in birth weight and were more likely to be admitted to the Neonatal Intensive Care Unit (NICU) compared to infants whose mothers did not take cannabis during pregnancy. [R]

However, two studies in 2010 and 2016 concluded that cannabis use during pregnancy is not an independent risk factor for low birth weight, preterm birth, and other adverse neonatal outcomes. The association between cannabis and adverse outcomes can be attributed to confounding factors such as tobacco and alcohol use. [R] [R]

In a July 2011 review, researchers looked at two previous human studies on the lasting impact of prenatal cannabis exposure and the role of endocannabinoids in the developing brain. The two longitudinal cohort studies are the Ottawa Prenatal Prospective Study (OPPS) and the Maternal Health Practices and Child Development Study (MHPCDS). [R]

The OPPS, published in 1978, focused on assessing prenatal exposure effects of tobacco and marijuana in middle-class Canadian women. Psychologist Peter Fried and his colleagues at the Carleton University in Ottawa administered hundreds of tests to about 145 children over a 22-year period. The group assessed physical development, cognitive function, intellectual capacity, psychomotor ability, and emotional and psychological adjustment.

Dr. Fried estimated that prenatal exposure to alcohol, tobacco, and marijuana accounted for 8 percent or less of the variance in scores on developmental and cognitive tests. Physically, marijuana exposure did not affect head circumference at the mid-gestational stage (17–22 weeks), although a significant reduction in foot length and body weight was reported. The changes in body weight and foot length were not present at birth although head circumference grew larger at 8 months. These measurements are indicators of normal fetal development.

The MHPCD, published in 1982, focused mainly on prenatal alcohol and marijuana exposure in a group of low-income, Caucasian and African-American women from Pittsburgh, Pennsylvania.

In both the OPPS and MHPCDS, cannabis use during pregnancy was not associated with increased miscarriage rates, preterm deliveries or any other complications. Researchers found very few differences between children who were exposed to marijuana and those who were not. However, cannabis-exposed babies were reportedly prone to startles, irritability, and had disrupted sleep patterns.

Another longitudinal study conducted in Jamaica in the 1980s compared cannabis-exposed and non-exposed children shortly after birth and at toddler age. [R]

Dr. Melanie Dreher, a pediatrician, examined 44 Jamaican children who were exposed to cannabis prenatally. Published by the American Academy of Pediatrics in 1994, the study included 24 newborns that were exposed to marijuana and 20 newborns that were not exposed. Dr. Dreher found no significant differences among infants on the third day after birth. After a month, the cannabis-exposed infants demonstrated better physiological stability. The newborns of heavy marijuana users also scored better on autonomic stability, alertness quality, irritability, and self-regulation. These infants were judged as “more rewarding for caregivers.” At five years of age, both infant groups showed no significant difference in health or achievement. [R]

The Jamaican study, however, did not look into health issues related to cannabis exposure.

Dr. Lynn Zimmer, professor of sociology at Queens College in New York, and John Morgan, professor of pharmacology at City University Medical School, conducted a review of existing literature for the Drug Policy Alliance in 1997. Among their conclusions are:

  • Outcomes vary from one study to another
  • Marijuana contributes less than alcohol or tobacco
  • Findings show no consistent relationship of fetal harm to degree or timing of marijuana exposure
  • There is no evidence that marijuana directly harms a human fetus

In 2016, the British Medical Journal published a systematic review of 24 studies. Some of the findings include:

  • Increased anemia in mothers
  • Decreased birth weight
  • Increased NICU admissions
  • Studies relied on self-reported use of cannabis
  • Cannabis use included tobacco and alcohol use in most studies
  • Studies often showed conflicting results, making it impossible to draw definitive conclusions

In another 2016 report, Dr. Shayna Conner conducted several studies on the effect of cannabis exposure on postnatal development complications in babies. Dr. Conner and her team found that cannabis alone did not cause birth complications or development issues but had a different result when combined with tobacco. [R]

The following year, the National Academies of Medicine published a review on the health effects of cannabis and cannabinoids. One section of this 468-page report was dedicated to prenatal, perinatal, and neonatal exposure to cannabis. The only adverse outcome with substantial evidence was lower birth weight in infants. There was limited evidence for pregnancy complications and increased NICU admissions. And there was insufficient evidence for SIDS, academic underachievement, and substance abuse in later years.

A study in 2018 seemed to confirm that cannabis exposure during pregnancy is associated with low birth weights. According to Colorado researchers, prenatal cannabis use increased the likelihood of low birth weight by 50 percent, setting the stage for serious health problems in the future including infection and NICU admission.

To this day, existing medical literature on the effects of cannabis exposure on a fetus continues to demonstrate contradictory results.

CBD vs. THC

CBD vs. THC

Many people still confuse marijuana with hemp. While both plants come from same the cannabis family, they produce very different effects. Marijuana plants contain more THC – the psychoactive cannabinoid. Hemp plants contain a higher concentration of CBD – the cannabinoid that has shown promise in treating many conditions without the psychoactive high.

Any marijuana extract that contains THC is harmful to pregnant women. Avoid marijuana at all costs to ensure infant health, wellness and survival.

Hemp plants may contain trace amounts of THC but no more than 0.3 percent. This makes it impossible to get high when taking CBD that has been extracted from hemp. CBD hemp oil is legal in most countries and is considered safe for elderly people, children, and even pets.

Clinical studies have proven that CBD has the ability to reduce nausea and vomiting – two of the most common symptoms of morning sickness in pregnant women. [R]

CBD is also known for its anxiolytic and analgesic properties which might be able to help with anxiety, appetite, mood, and pain management.

One researcher even suggested in 2009 that the neuroprotective, anti-psychotic, and anti-anxiety properties of CBD may help treat the negative effects of prenatal THC exposure. [R]

However, the lack of research makes it very difficult to determine how CBD could affect mom and fetus during pregnancy.

CBD and pregnancy

CBD and pregnancy

CBD and pregnancy is a highly controversial topic. One side of the debate claims that with the absence of significant research and clinical trials, taking CBD may not be worth putting the fetus at risk. The other side argues that CBD has already been proven to be much safer than most prescription medications – making it ideal for pregnant women who have to deal with side effects such as nausea, cramps, fatigue, stress, inflammation, muscle and back soreness, and anxiety. CBD does not have the same psychoactive effects of THC. It is an organic substance that might be able to ease the physical and mental strain of pregnancy.

Unlike tobacco and nicotine, studies on the effect of CBD on pregnancy are few and far between. [R]

Here a couple of promising ones that may shed light on the topic.

Early pregnancy

Early pregnancy

One rodent study in 2006 found that CBD was not associated with the same risks as THC. [R]

Researchers compared the effects of three cannabinoids – THC, CBD, and CBN – on mice during the early stages of pregnancy. The subjects were given 5/mg of purified cannabinoids per kilo of body weight daily. In humans, this would be equivalent to 306mg of THC, CBD, or CBN for a 135-pound (61kg) woman.

While THC caused poor implantation, ovulation alterations, and self-destruction of embryonic cells, none of these events were observed with CBD and CBN. The mice embryo developed normally but no one can tell if this can also apply to humans.

Contractions

Contractions

Because CBD can help relax the muscles, it might be able to help women with contractions.

In 2010, a group of researchers conducted an experiment where synthetic CBD was applied to cells cultured outside of the body. The study concluded that CBD could reduce oxytocin-induced myometrial (uterine) contractions the same way oxytocin antagonist drugs do. Oxytocin antagonists such as Atosiban are injected intravenously in mothers experiencing preterm contractions. Actual human studies are needed to determine if this applies consistently. [R]

Placenta

 

PlacentaTwo separate clinical studies were conducted in 2013 to investigate the effect of CBD on the placenta. Researchers found that prenatal CBD treatment may increase the permeability of the placenta and allow foreign compounds to cross the placental barrier and reach the fetus. If CBD alters the physiological characteristics of the placenta it could pose a great danger to the fetus. However, there is no indication as to how CBD will affect the placenta inside an actual human body. Also, the researchers applied CBD to the placenta over a period of 24 to 72 hours. Actual expecting mothers would take CBD in a much smaller dose and spaced out across longer periods.

[R] [R]

The American Congress of Obstetricians and Gynecologists (ACOG) discourages pregnant women and lactating mothers from consuming marijuana for good reason – studies have shown that marijuana can have adverse affects on the endocannabinoid system which is responsible for fetal brain development.

Dr. Talitha Burney, medical director for the Comprehensive Family Care Centre at the Montefiore Health System, admits that while she does recognize the health benefits of CBD, there are key factors why the ACOG does not recommend cannabinoids for expecting moms. These factors include:

  • The absence of government regulation on dosage and formulation
  • The absence of FDA approval
  • Lack of clinical trials on how CBD affects pregnant women and their unborn child

Most of the scientific evidence available focuses on how CBD can help with seizure disorders, multiple sclerosis, pain management, and anxiety with no specific focus on pregnancy.

Is CBD safe for pregnant women?

Is CBD safe for pregnant women?

While anecdotal reports about CBD and pregnancy continue to grow, there are no extensive human studies to date. Many expecting mothers are taking CBD to help with morning sickness, pain, inflammation, and sleeping difficulties but there is no way to completely guarantee the safety of prenatal exposure to CBD because the science is lacking.

Because of the crucial role the endocannabinoid system plays in fetal development, there is a risk in introducing cannabinoids to a developing brain. Everything you consume could have an impact on your baby and CBD – even though it does not contain THC – has not been studied enough to absolutely know if it is totally risk-free.

If you are pregnant and are wondering if you could take CBD to ease your symptoms, the best thing to do is talk to your doctor. Do not try any new medication or make changes to a birth plan without consulting a prenatal care physician.

In many cases, it comes down to individual choice. Pregnancy can be very rough for some women. The nausea can last all day long and keeping food down can be a struggle. When presented with the choice between taking prescription medication or hemp-derived organic CBD, you must decide based on what you feel comfortable with and the amount of risk you are willing to take.

If you decide to take CBD while you are pregnant

If you decide to take CBD while you are pregnant

For some women, morning sickness can be debilitating. If after talking to your doctor you do decide to take CBD during your pregnancy, here are some important tips to consider.

  • Make sure the CBD product you are taking is organic and non-GMO
  • Check if the hemp source is grown without pesticides or other chemicals
  • Avoid CBD tinctures that are extracted with ethanol or other alcohol
  • Ask for a complete list of ingredients
  • Ask for a copy of third party testing results
  • Avoid THC
  • Avoid smoking – look for edible or topical CBD products
  • Micro dose and use only as needed

Best route of administration

Best route of administration

Smoking or vaporizing flowers is not the best way to take CBD as the process can produce harmful substances that could affect the child you are carrying. Even CBD-dominant strains could contain traces of THC.

The most ideal route of administration is ingestion through CBD-rich edibles, and the best CBD edibles are the ones you make from scratch. If you do not have the time or do not want to put in the effort to make your own edibles, be sure to buy them from a reputable retailer and consume a controlled dosage.

CBD that comes in the form of oil, paste, capsule or lotion are also good options. Pregnant women who suffer from soreness can simply apply CBD cream on the affected area for pain relief. You can make your own salve or purchase a topical CBD product online.

If you feel that you might be able to benefit from taking CBD during your pregnancy and are willing to take the risk despite the lack of science guaranteeing its safety, talk to your prenatal care provider today.


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