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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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