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Association between gestational cannabis exposure and maternal, perinatal, placental, and childhood outcomes

Published online by Cambridge University Press:  07 December 2020

Oyekoya T. Ayonrinde Open the ORCID record for Oyekoya T. Ayonrinde [Opens in a new window] ,
Oyedeji A. Ayonrinde ,
Derrick Van Rooyen ,
Robert Tait ,
Mikaela Dunn ,
Shailender Mehta ,
Scott White  and
Oyekunle K. Ayonrinde
Oyekoya T. Ayonrinde*
Affiliation:
Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch, WA, Australia Medical School, The University of Western Australia, Nedlands, WA, Australia Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
Oyedeji A. Ayonrinde
Affiliation:
Department of Psychiatry, Queens University, Kingston, ON, Canada Providence Care Hospital, Kingston, ON, Canada
Derrick Van Rooyen
Affiliation:
Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch, WA, Australia
Robert Tait
Affiliation:
National Drug Research Institute, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
Mikaela Dunn
Affiliation:
Medical School, The University of Western Australia, Nedlands, WA, Australia
Shailender Mehta
Affiliation:
Faculty of Health Sciences, Curtin University, Bentley, WA, Australia Neonatology Unit, Fiona Stanley Hospital, Murdoch, WA, Australia School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia
Scott White
Affiliation:
Medical School, The University of Western Australia, Nedlands, WA, Australia Maternal Fetal Medicine Service, King Edward Memorial Hospital, Subiaco, WA, Australia
Oyekunle K. Ayonrinde
Affiliation:
Department of Paediatrics, Chesterfield Royal Hospital, Chesterfield, UK
*
Address for correspondence: Dr Oyekoya Ayonrinde, Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch, WA 6150, Australia. Email: [email protected]
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Abstract

Globally, the availability and formulations for the administration of cannabis are changing with decriminalization or legalization of recreational use in some jurisdictions, and the prescription of cannabis also occurring. These changes are likely to affect the prevalence of use, including by women of childbearing age. The effects of in utero and infant alcohol and tobacco exposure are well-documented, but the outcomes of cannabis exposure are less certain. The content of delta-9-tetrahydrocannabinol (THC), the psychoactive component of cannabis has progressively increased over several decades. This review explores the limited knowledge surrounding the epidemiology of gestational and postnatal cannabis exposure and implications for the mother–placenta–fetus/neonate triad. We examine cannabis’ effects from antenatal and lactation exposure on (a) pregnancy and perinatal outcomes, (b) placental health, and (c) longer term cardiometabolic and neurodevelopmental risks and outcomes. Though definitive outcomes are lacking, gestational cannabis has been associated with increased risk of other substance use during pregnancy; impaired placental blood flow; increased risk of small for gestational age births; and associated complications. Childhood and adolescent outcomes are sparsely assessed, with suggested outcomes including increased risk of depression and attention-deficit hyperactivity disorder. Cardiometabolic implications of gestational cannabis use may include maternal fatty liver, obesity, insulin resistance, and increased risk of gestational diabetes mellitus (GDM), with potential consequences for the fetus. Clinical implications for pediatric practice were explored in a bid to understand any potential risk or impact on child health and development.

Keywords

Cannabispregnancyfetusplacentamaternal
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 12 , Issue 5 , October 2021 , pp. 694 - 703
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Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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References

Ayonrinde, OA. Cannabis and psychosis: revisiting a nineteenth century study of ‘Indian Hemp and Insanity’ in Colonial British India. Psychol Med. 2020; 50, 1164–1172.CrossRefGoogle ScholarPubMed
Hall, W, Stjepanović, D, Caulkins, J, et al. Public health implications of legalising the production and sale of cannabis for medicinal and recreational use. Lancet. 2019; 394, 1580–1590.CrossRefGoogle ScholarPubMed
Andrews, CN, Devlin, SM, Le Foll, B, et al. Canadian association of gastroenterology position statement: use of cannabis in gastroenterological and hepatic disorders. J Can Assoc Gastroenterol. 2019; 2, 37–43.Google Scholar
Nelson, SE, Van Ryzin, MJ, Dishion, TJ. Alcohol, marijuana, and tobacco use trajectories from age 12 to 24 years: demographic correlates and young adult substance use problems. Dev Psychopathol. 2015; 27, 253–277.CrossRefGoogle Scholar
Silins, E, Horwood, LJ, Najman, JM, et al. Adverse adult consequences of different alcohol use patterns in adolescence: an integrative analysis of data to age 30 years from four Australasian cohorts. Addiction. 2018; 113, 1811–1825.CrossRefGoogle ScholarPubMed
Hyman, SM, Sinha, R. Stress-related factors in cannabis use and misuse: implications for prevention and treatment. J Subst Abuse Treat. 2009; 36, 400–413.CrossRefGoogle ScholarPubMed
Bahji, A, Stephenson, C. International perspectives on the implications of cannabis legalization: a systematic review & thematic analysis. Int J Environ Res Public Health. 2019; 16(17), 3095.CrossRefGoogle ScholarPubMed
Australian Institute of Health and Welfare. Australia’s health 2016. Australia’s health series no. 15.Cat. no. AUS 199. Canberra: AIHW, 2016. Available from https://www.aihw.gov.au/getmedia/9844cefb-7745–4dd8–9ee2-f4d1c3d6a727/19787-AH16.pdf.aspx (accessed on 25 February 2020).Google Scholar
Australian Institute of Health and Welfare. National Drug Strategy Household Survey 2016: detailed findings. Drug Statistics series no. 31. Cat. no. PHE 214. Canberra: AIHW, 2017. Available from https://www.aihw.gov.au/getmedia/15db8c15–7062–4cde-bfa4–3c2079f30af3/21028a.pdf.aspx?inline=true (accessed on 25 February 2020).Google Scholar
Canadian Cannabis Survey 2019 – Summary. https://www.canada.ca/en/health-canada/services/publications/drugs-health-products/canadian-cannabis-survey-2019-summary.html (accessed on 5 June 2020).Google Scholar
Committee on Obstetric Practice. Committee opinion no. 722: marijuana use during pregnancy and lactation. Obstet Gynecol. 2017; 130(4), e205–e209.CrossRefGoogle Scholar
World Drug Report 2018 (United Nations publication, Sales No. E.18.XI.9). Women and Drugs. Drug Use, Drug Supply and Their Consequences. https://www.unodc.org/wdr2018/prelaunch/WDR18_Booklet_5_WOMEN.pdf (accessed 23 August 2020).Google Scholar
Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services. 2018 National Survey on Drug Use and Health: Women. https://www.samhsa.gov/data/sites/default/files/reports/rpt23250/5_Women_2020_01_14_508.pdf (accessed 5 June 2020).Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2018: Trends and Developments, Luxembourg, Publications Office of the European Union. 2018. https://www.emcdda.europa.eu/system/files/publications/8585/20181816_TDAT18001ENN_PDF.pdf (accessed 5 June 2020).Google Scholar
Passey, ME, Sanson-Fisher, RW, D’Este, CA, Stirling, JM. Tobacco, alcohol and cannabis use during pregnancy: clustering of risks. Drug Alcohol Depend. 2014; 134, 44–50.CrossRefGoogle ScholarPubMed
Leemaqz, SY, Dekker, GA, McCowan, LM, et al. Maternal marijuana use has independent effects on risk for spontaneous preterm birth but not other common late pregnancy complications. Reprod Toxicol. 2016; 62, 77–86.CrossRefGoogle Scholar
Grant, KS, Petroff, R, Isoherranen, N, Stella, N, Burbacher, TM. Cannabis use during pregnancy: Pharmacokinetics and effects on child development. Pharmacol Ther. 2018; 182, 133–151.CrossRefGoogle ScholarPubMed
Brown, SJ, Mensah, FK, Ah Kit, J, et al. Use of cannabis during pregnancy and birth outcomes in an Aboriginal birth cohort: a cross-sectional, population-based study. BMJ Open. 2016; 6, e010286.CrossRefGoogle Scholar
van Gelder, MM, Reefhuis, J, Caton, AR, et al. Characteristics of pregnant illicit drug users and associations between cannabis use and perinatal outcome in a population-based study. Drug Alcohol Depend. 2010; 109, 243–247.CrossRefGoogle ScholarPubMed
Fergusson, DM, Horwood, LJ, Northstone, K; ALSPAC Study Team. Avon longitudinal study of pregnancy and childhood. Maternal use of cannabis and pregnancy outcome. BJOG. 2002; 109, 21–27.CrossRefGoogle ScholarPubMed
Volkow, ND, Han, B, Compton, WM, McCance-Katz, EF. Self-reported medical and nonmedical cannabis use among pregnant women in the United States. JAMA. 2019; 322, 167–169.CrossRefGoogle ScholarPubMed
Young-Wolff, KC, Sarovar, V, Tucker, LY, et al. Self-reported daily, weekly, and monthly cannabis use among women before and during pregnancy. JAMA Netw Open. 2019; 2(7), e196471.CrossRefGoogle ScholarPubMed
Metz, TD, Borgelt, LM. Marijuana use in pregnancy and while breastfeeding. Obstet Gynecol. 2018; 132, 1198–1210.CrossRefGoogle ScholarPubMed
Roberson, EK, Patrick, WK, Hurwitz, EL. Marijuana use and maternal experiences of severe nausea during pregnancy in Hawai’i. Hawaii J Med Public Health. 2014; 73(9), 283–287.Google ScholarPubMed
Gnofam, M, Allshouse, AA, Stickrath, EH, Metz, TD. Impact of marijuana legalization on prevalence of maternal marijuana use and perinatal outcomes. Am J Perinatol. 2020; 37, 59–65.Google ScholarPubMed
Kharbanda, EO, Vazquez-Benitez, G, Kunin-Batson, A, Nordin, JD, Olsen, A, Romitti, PA. Birth and early developmental screening outcomes associated with cannabis exposure during pregnancy. J Perinatol. 2020; 40, 473–480.CrossRefGoogle ScholarPubMed
Hayatbakhsh, MR, Flenady, VJ, Gibbons, KS, et al. Birth outcomes associated with cannabis use before and during pregnancy. Pediatr Res. 2012; 71, 215–219.CrossRefGoogle ScholarPubMed
Moster, D, Lie, RT, Markestad, T. Long-term medical and social consequences of preterm birth. N Engl J Med. 2008; 359, 262–273.CrossRefGoogle ScholarPubMed
Calkins, K, Devaskar, SU. Fetal origins of adult disease. Curr Probl Pediatr Adolesc Health Care. 2011; 41, 158–176.CrossRefGoogle ScholarPubMed
Cianfarani, S, Agostoni, C, Bedogni, G, et al. Effect of intrauterine growth retardation on liver and long-term metabolic risk. Int J Obes (Lond). 2012; 36, 1270–1277.CrossRefGoogle ScholarPubMed
Saenger, P, Czernichow, P, Hughes, I, Reiter, EO. Small for gestational age: short stature and beyond. Endocr Rev. 2007; 28, 219–251.CrossRefGoogle ScholarPubMed
Moster, D, Lie, RT, Markestad, T. Long-term medical and social consequences of preterm birth. N Engl J Med. 2008; 359, 262–273.CrossRefGoogle ScholarPubMed
Popova, S, Lange, S, Probst, C, Gmel, G, Rehm, J. Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: a systematic review and meta-analysis. Lancet Glob Health. 2017; 5, e290–e299.CrossRefGoogle ScholarPubMed
Corsi, DJ, Walsh, L, Weiss, D, et al. Association between self-reported prenatal cannabis use and maternal, perinatal, and neonatal outcomes. JAMA. 2019; 322, 145–152.CrossRefGoogle ScholarPubMed
Metz, TD, Allshouse, AA, Hogue, CJ, et al. Maternal marijuana use, adverse pregnancy outcomes, and neonatal morbidity. Am J Obstet Gynecol. 2017; 217, 478.e1–478.e8.CrossRefGoogle ScholarPubMed
Metz, TD, Stickrath, EH. Marijuana use in pregnancy and lactation: a review of the evidence. Am J Obstet Gynecol. 2015; 213, 761–778.CrossRefGoogle Scholar
Mourh, J, Rowe, H. Marijuana and breastfeeding: applicability of the current literature to clinical practice. Breastfeed Med. 2017; 12, 582–596.CrossRefGoogle ScholarPubMed
Liston, J. Breastfeeding and the use of recreational drugs--alcohol, caffeine, nicotine and marijuana. Breastfeed Rev. 1998; 6, 27–30.Google ScholarPubMed
Ayonrinde, OT, Oddy, WH, Adams, LA, et al. Infant nutrition and maternal obesity influence the risk of non-alcoholic fatty liver disease in adolescents. J Hepatol. 2017; 67, 568–576.CrossRefGoogle ScholarPubMed
National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research, 2017. National Academies Press (US), Washington, DC. Recommendations to Support and Improve the Cannabis Research Agenda. Available from: https://www.ncbi.nlm.nih.gov/books/NBK425745/ (accessed 10 February 2020).Google Scholar
Canadian Institutes of Health Research. Integrated Cannabis Research Strategy, 2019. Available from: https://cihr-irsc.gc.ca/e/51352.html (accessed 8 June 2020).Google Scholar
Gunn, JK, Rosales, CB, Center, KE, et al. Prenatal exposure to cannabis and maternal and child health outcomes: a systematic review and meta-analysis. BMJ Open. 2016; 6, e009986.CrossRefGoogle ScholarPubMed
Food Standards Agency Newsletter, 2020. Available from: https://www.food.gov.uk/print/pdf/node/3721 (accessed 8 June 2020).Google Scholar
Zurolo, E, Iyer, AM, Spliet, WG, et al. CB1 and CB2 cannabinoid receptor expression during development and in epileptogenic developmental pathologies. Neuroscience. 2010; 170, 28–41.CrossRefGoogle ScholarPubMed
Marsicano, G, Goodenough, S, Monory, K, et al. CB1 cannabinoid receptors and on-demand defense against excitotoxicity. Science. 2003; 302, 84–88.CrossRefGoogle ScholarPubMed
Oka, S, Ishima, Y, Waku, K, Sugiura, T. Endocannabinoids as retrograde messengers in synaptic transmission. In Endocannabinoids: The Brain and Body’s Marijuana and Beyond (eds. Onaivi, ES, Sugiura, T, Di Marzo, V), 2006; pp. 133–149. CRC: Boca Raton, FL.Google Scholar
Matsuda, LA, Lolait, SJ, Brownstein, MJ, Young, AC, Bonner, TI. Structure of a cannabinoid receptor and functional expression of the cloned cDNA. Nature. 1990; 346, 561–564.CrossRefGoogle ScholarPubMed
Klein, TW, Newton, C, Larsen, K, et al. The cannabinoid system and immune modulation. J Leukoc Biol. 2003; 74, 486–496.CrossRefGoogle ScholarPubMed
Lombard, C, Nagarkatti, M, Nagarkatti, P. CB2 cannabinoid receptor agonist, JWH-015, triggers apoptosis in immune cells: potential role for CB2-selective ligands as immunosuppressive agents. Clin Immunol. 2007; 122(3), 259–270.CrossRefGoogle ScholarPubMed
Tomar, S, Zumbrun, EE, Nagarkatti, M, Nagarkatti, PS. Protective role of cannabinoid receptor 2 activation in galactosamine/lipopolysaccharide-induced acute liver failure through regulation of macrophage polarization and microRNAs. J Pharmacol Exp Ther. 2015; 353(2), 369–379.CrossRefGoogle ScholarPubMed
World Health Organization. The Health and Social Effects of Nonmedical Cannabis Use, 2016. World Health Organization. https://apps.who.int/iris/handle/10665/251056.Google Scholar
Taylor, AH, Amoako, AA, Bambang, K, et al. Endocannabinoids and pregnancy. Clin Chim Acta. 2010; 411, 921–930.CrossRefGoogle Scholar
Maia, J, Midão, L, Cunha, SC, et al. Effects of cannabis tetrahydrocannabinol on endocannabinoid homeostasis in human placenta. Arch Toxicol. 2019; 93(3), 649–658.CrossRefGoogle ScholarPubMed
Benevenuto, SG, Domenico, MD, Martins, MA, et al. Recreational use of marijuana during pregnancy and negative gestational and fetal outcomes: an experimental study in mice. Toxicology. 2017; 376, 94–101.CrossRefGoogle ScholarPubMed
Carter, RC, Wainwright, H, Molteno, CD, et al. Alcohol, Methamphetamine, and Marijuana Exposure Have Distinct Effects on the Human Placenta. Alcohol Clin Exp Res. 2016; 40, 753–764.CrossRefGoogle ScholarPubMed
El Marroun, H, Tiemeier, H, Steegers, EA, et al. A prospective study on intrauterine cannabis exposure and fetal blood flow. Early Hum Dev. 2010; 86, 231–236.CrossRefGoogle ScholarPubMed
Brar, BK, Patil, PS, Jackson, DN, Gardner, MO, Alexander, JM, Doyle, NM. Effect of intrauterine marijuana exposure on fetal growth patterns and placental vascular resistance. J Matern Fetal Neonatal Med. 2019; 1–5.Google ScholarPubMed
Natale, BV, Gustin, KN, Lee, K, et al. Δ9-tetrahydrocannabinol exposure during rat pregnancy leads to symmetrical fetal growth restriction and labyrinth-specific vascular defects in the placenta. Sci Rep. 2020; 10, 544.CrossRefGoogle ScholarPubMed
Roncero, C, Valriberas-Herrero, I, Mezzatesta-Gava, M, Villegas, JL, Aguilar, L, Grau-López, L. Cannabis use during pregnancy and its relationship with fetal developmental outcomes and psychiatric disorders. A systematic review. Reprod Health. 2020; 17, 25.CrossRefGoogle ScholarPubMed
Hahn, T, Barth, S, Graf, R, et al. Placental glucose transporter expression is regulated by glucocorticoids. J Clin Endocrinol Metab. 1999; 84, 1445–1452.Google ScholarPubMed
Darke, S, Duflou, J, Farrell, M, Peacock, A, Lappin, J. Characteristics and circumstances of synthetic cannabinoid-related death. Clin Toxicol (Phila). 2020; 58, 368–374.CrossRefGoogle ScholarPubMed
Tait, RJ, Caldicott, D, Mountain, D, Hill, SL, Lenton, S. A systematic review of adverse events arising from the use of synthetic cannabinoids and their associated treatment. Clin Toxicol (Phila). 2016; 54, 1–13.CrossRefGoogle ScholarPubMed
Neradugomma, NK, Drafton, K, Mor, GG, Mao, Q. Marijuana-derived cannabinoids inhibit uterine endometrial stromal cell decidualization and compromise trophoblast-endometrium cross-talk. Reprod Toxicol. 2019; 87, 100–107.CrossRefGoogle ScholarPubMed
Lojpur, T, Easton, Z, Raez-Villanueva, S, Laviolette, S, Holloway, AC, Hardy, DB. Δ9-Tetrahydrocannabinol leads to endoplasmic reticulum stress and mitochondrial dysfunction in human BeWo trophoblasts. Reprod Toxicol. 2019; 87, 21–31.CrossRefGoogle ScholarPubMed
Almada, M, Costa, L, Fonseca, BM, Amaral, C, Teixeira, N, Correia-da-Silva, G. The synthetic cannabinoid WIN-55,212 induced-apoptosis in cytotrophoblasts cells by a mechanism dependent on CB1 receptor. Toxicology. 2017; 385, 67–73.CrossRefGoogle ScholarPubMed
Fonseca, BM, Fernandes, R, Almada, M, et al. Synthetic cannabinoids and endometrial stromal cell fate: dissimilar effects of JWH-122, UR-144 and WIN55,212–2. Toxicology. 2019; 413, 40–47.CrossRefGoogle ScholarPubMed
Almada, M, Alves, P, Fonseca, BM, et al. Synthetic cannabinoids JWH-018, JWH-122, UR-144 and the phytocannabinoid THC activate apoptosis in placental cells. Toxicol Lett. 2020; 319, 129–137.CrossRefGoogle ScholarPubMed
Gray, KA, Day, NL, Leech, S, Richardson, GA. Prenatal marijuana exposure: effect on child depressive symptoms at ten years of age. Neurotoxicol Teratol. 2005; 27, 439–448.CrossRefGoogle ScholarPubMed
Goldschmidt, L, Richardson, GA, Cornelius, MD, Day, NL. Prenatal marijuana and alcohol exposure and academic achievement at age 10. Neurotoxicol Teratol. 2004; 26, 521–532.CrossRefGoogle ScholarPubMed
Day, NL, Goldschmidt, L, Thomas, CA. Prenatal marijuana exposure contributes to the prediction of marijuana use at age 14. Addiction. 2006; 101, 1313–1322.CrossRefGoogle ScholarPubMed
Derauf, C, Kekatpure, M, Neyzi, N, Lester, B, Kosofsky, B. Neuroimaging of children following prenatal drug exposure. Semin Cell Dev Biol. 2009; 20, 441–454.CrossRefGoogle ScholarPubMed
Warshak, CR, Regan, J, Moore, B, Magner, K, Kritzer, S, Van Hook, J. Association between marijuana use and adverse obstetrical and neonatal outcomes. J Perinatol. 2015; 35, 991–995.CrossRefGoogle ScholarPubMed
Conner, SN, Bedell, V, Lipsey, K, Macones, GA, Cahill, AG, Tuuli, MG. Maternal marijuana use and adverse neonatal outcomes: a systematic review and meta-analysis. Obstet Gynecol. 2016; 128(4), 713–723.CrossRefGoogle ScholarPubMed
Varner, MW, Silver, RM, Rowland Hogue, CJ, et al. Association between stillbirth and illicit drug use and smoking during pregnancy. Obstet Gynecol. 2014; 123, 113–125.CrossRefGoogle ScholarPubMed
Crean, RD, Crane, NA, Mason, BJ. An evidence based review of acute and long-term effects of cannabis use on executive cognitive functions. J Addict Med. 2011; 5, 1–8.CrossRefGoogle ScholarPubMed
Cohen, K, Weinstein, A. The effects of cannabinoids on executive functions: evidence from cannabis and synthetic cannabinoids-a systematic review. Brain Sci. 2018; 8, 40.CrossRefGoogle ScholarPubMed
Forrester, MB, Merz, RD. Risk of selected birth defects with prenatal illicit drug use, Hawaii, 1986–2002. J Toxicol Environ Health A. 2007; 70(1), 7–18.CrossRefGoogle ScholarPubMed
Reece, AS, Hulse, GK. Gastroschisis and autism-dual canaries in the Californian coalmine. JAMA Surg. 2019; 154(4), 366–367.CrossRefGoogle ScholarPubMed
David, AL, Holloway, A, Thomasson, L, et al. A case-control study of maternal periconceptual and pregnancy recreational drug use and fetal malformation using hair analysis. PLoS One. 2014; 9, e111038.CrossRefGoogle ScholarPubMed
Siega-Riz, AM, Keim-Malpass, J, Lyons, GR, Alhusen, J. The association between legalization of recreational marijuana use and birth outcomes in Colorado and Washington state. Birth Defects Res. 2020; 112(9), 660–669.CrossRefGoogle ScholarPubMed
Baker, T, Datta, P, Rewers-Felkins, K, et al. Transfer of inhaled cannabis into human breast milk. Obstet Gynecol. 2018; 131, 783.CrossRefGoogle ScholarPubMed
Bertrand, KA, Hanan, NJ, Honerkamp-Smith, G, Best, BM, Chambers, CD. Marijuana use by breastfeeding mothers and cannabinoid concentrations in breast milk. Pediatrics. 2018; 142(3), e20181076.CrossRefGoogle ScholarPubMed
Tennes, K, Avitable, N, Blackard, C, et al. Marijuana: prenatal and postnatal exposure in the human. NIDA Res Monogr. 1985; 59, 48–60.Google ScholarPubMed
Astley, SJ, Little, RE. Maternal marijuana use during lactation and infant development at one year. Neurotoxicol Teratol. 1990; 12, 161.CrossRefGoogle ScholarPubMed
World Health Organization. Guidelines for the Identification and Management of Substance Use and Substance Use Disorders in Pregnancy, 2014. World Health Organization. https://apps.who.int/iris/handle/10665/107130.Google Scholar
Gunasekaran, N, Long, LE, Dawson, BL, Hansen, GH, Richardson, DP, Li, KM, Arnold, JC, McGregor, IS. Reintoxication: the release of fat-stored delta(9)-tetrahydrocannabinol (THC) into blood is enhanced by food deprivation or ACTH exposure. Br J Pharmacol. 2009; 158, 1330–1337.CrossRefGoogle ScholarPubMed
Hirsch, S, Tam, J. Cannabis: from a plant that modulates feeding behaviors toward developing selective inhibitors of the peripheral endocannabinoid system for the treatment of obesity and metabolic syndrome. Toxins (Basel). 2019; 11, 275.CrossRefGoogle ScholarPubMed
Bermudez-Silva, FJ, Viveros, MP, McPartland, JM, Rodriguez de Fonseca, F. The endocannabinoid system, eating behavior and energy homeostasis: the end or a new beginning? Pharmacol Biochem Behav. 2010; 95, 375–382.CrossRefGoogle ScholarPubMed
Christensen, R, Kristensen, PK, Bartels, EM, Bliddal, H, Astrup, A. Efficacy and safety of the weight-loss drug rimonabant: a meta-analysis of randomised trials. Lancet. 2007; 370, 1706–1713.CrossRefGoogle ScholarPubMed
Julien, B, Grenard, P, Teixeira-Clerc, F, et al. Antifibrogenic role of the cannabinoid receptor CB2 in the liver. Gastroenterology. 2005; 128, 742–755.CrossRefGoogle ScholarPubMed
Dai, E, Zhang, L, Ye, L, et al. Hepatic expression of cannabinoid receptors CB1 and CB2 correlate with fibrogenesis in patients with chronic hepatitis B. Int J Infect Dis. 2017; 59, 124–130.CrossRefGoogle ScholarPubMed
Jeong, WI, Osei-Hyiaman, D, Park, O, et al. Paracrine activation of hepatic CB1 receptors by stellate cell-derived endocannabinoids mediates alcoholic fatty liver. Cell Metab. 2008; 7, 227–235.CrossRefGoogle ScholarPubMed
Lee, SM, Kim, BJ, Koo, JN, et al. Nonalcoholic fatty liver disease is a risk factor for large-for-gestational-age birthweight. PLoS One. 2019; 14, e0221400.CrossRefGoogle ScholarPubMed
Bhatt, S., Queen, J. Cannabinoid hyperemesis syndrome. Curr Emerg Hosp Med Rep. 2019; 7, 14–18.CrossRefGoogle Scholar
Aziz, I, Palsson, OS, Whitehead, WE, Sperber, AD, Simrén, M, Törnblom, H. Epidemiology, clinical characteristics, and associations for Rome IV functional Nausea and vomiting disorders in adults. Clin Gastroenterol Hepatol. 2019; 17, 878–886.CrossRefGoogle ScholarPubMed
Patel, RS, Goyal, H, Satodiya, R, Tankersley, WE. Relationship of cannabis use disorder and irritable bowel syndrome (IBS): an analysis of 6.8 million hospitalizations in the United States. Subst Use Misuse. 2020; 55, 281–290.CrossRefGoogle ScholarPubMed
Adejumo, AC, Ajayi, TO, Adegbala, OM, Bukong, TN. Higher odds of irritable bowel syndrome among hospitalized patients using cannabis: a propensity-matched analysis. Eur J Gastroenterol Hepatol. 2019; 31, 756–765.CrossRefGoogle ScholarPubMed
Russo, EB. Clinical endocannabinoid deficiency reconsidered: current research supports the theory in migraine, fibromyalgia, irritable bowel, and other treatment-resistant syndromes. Cannabis Cannabinoid Res. 2016; 1, 154–165.CrossRefGoogle ScholarPubMed
Goyal, H, Singla, U, Gupta, U, May, E. Role of cannabis in digestive disorders. Eur J Gastroenterol Hepatol. 2017; 29, 135–143.CrossRefGoogle ScholarPubMed
Fogel, JS, Kelly, TH, Westgate, PM, Lile, JA. Sex differences in the subjective effects of oral Δ9-THC in cannabis users. Pharmacol Biochem Behav. 2017; 152, 44–51.CrossRefGoogle ScholarPubMed
Cooper, ZD, Haney, M. Investigation of sex-dependent effects of cannabis in daily cannabis smokers. Drug Alcohol Depend. 2014; 136, 85–91.CrossRefGoogle ScholarPubMed
Meier, MH, Pardini, D, Beardslee, J, Matthews, KA. Associations between cannabis use and cardiometabolic risk factors: a longitudinal study of men. Psychosom Med. 2019; 81, 281–288.CrossRefGoogle ScholarPubMed
Hernandez, JM, Paty, J, Price, IM. Cannabinoid hyperemesis syndrome presentation to the emergency department: a two-year multicentre retrospective chart review in a major urban area. CJEM. 2018; 20, 550–555.CrossRefGoogle Scholar
Fattore, L, Fratta, W. How important are sex differences in cannabinoid action? Br J Pharmacol. 2010; 160, 544–548.CrossRefGoogle ScholarPubMed
Cuttler, C, Mischley, LK, Sexton, M. Sex differences in cannabis use and effects: a cross-sectional survey of cannabis users. Cannabis Cannabinoid Res. 2016; 1, 166–175.CrossRefGoogle ScholarPubMed
Craft, RM, Marusich, JA, Wiley, JL. Sex differences in cannabinoid pharmacology: a reflection of differences in the endocannabinoid system? Life Sci. 2013; 92, 476–481.CrossRefGoogle ScholarPubMed
Bara, A, Manduca, A, Bernabeu, A, et al. Sex-dependent effects of in utero cannabinoid exposure on cortical function. Elife. 2018; 7, e36234.CrossRefGoogle ScholarPubMed
Pacheco, M, Childers, SR, Arnold, R, Casiano, F, Ward, SJ. Aminoalkylindoles: actions on specific G-protein-linked receptors. J Pharmacol Exp Ther. 1991; 257, 170–183.Google ScholarPubMed
Mackie, K. Mechanisms of CB1 receptor signaling: endocannabinoid modulation of synaptic strength. Int J Obes (Lond). 2006; 30(Suppl 1), S19–S23.CrossRefGoogle ScholarPubMed