The American College of Obstetricians and Gynecologists (ACOG) has released new recommendations on cannabis use in pregnancy and breast feeding.
The prevalence of cannabis use — medicinal or recreational — among pregnant and lactating individuals ranges from 3.9% to 16.0% according to ACOG.
Cannabis used medicinally in pregnancy is most frequently associated with the first trimester for management of pre-existing conditions and pregnancy-related symptoms such as nausea and vomiting, weight gain, pain, and stress. However, researchers have suggested a link between cannabis use and Nausea and Vomiting in Pregnancy (NVP).
ACOG is now recommending universal screening for cannabis use during prepregnancy, pregnancy, and postpartum. The College has also expressed concern that even though cannabis use has long been associated with spontaneous preterm birth, low birth weight, NICU admissions, and postnatal neurocognitive and behavioral dysfunction, a misperception remains among the general public cannabis is safe for use during pregnancy.
“We still have a lot learn about the effects of cannabis on placental function, fetal growth and development, and long-term physical and mental health in the child,” said Melissa Russo, MD, FACOG and coauthor of the updated guidelines.
ACOG says obstetric health care professionals should educate patients that there are no medical indications for cannabis use during pregnancy and the postpartum period. As for breastfeeding:
“We want to discourage use of cannabis during lactation, but continued use is not a contraindication to breastfeeding,” said Amy Valent, DO, FACOG and coauthor of the guidance. “So, patients who want to breastfeed should be encouraged to do so because of the numerous health benefits it provides the newborn.”
While encouraging screening of patients, ACOG has also cautioned on structural racism and bias, and mandatory reporting requirements.
“Institutional and state policies can vary, so we as clinicians need to familiarize ourselves with those policies and the potential legal ramifications and effects testing will have on our patients and their families,” said Valent.
ACOG’s cannabis use during pregnancy and lactation guidelines can be found here.
Earlier this year, we reported on an updated systematic review and meta-analysis of dozens of studies that reaffirmed cannabis use in pregnancy can have adverse neonatal outcomes.
