ACOG Update: Marijuana Use Discouraged During Pregnancy, Breastfeeding

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The guidelines were updated to suggest that clinicians should inform patients about the reasons for marijuana screening (ie, to allow treatment of substance abuse and not for punishment).
The guidelines were updated to suggest that clinicians should inform patients about the reasons for marijuana screening (ie, to allow treatment of substance abuse and not for punishment).

In an interim update to a committee opinion published in Obstetrics & Gynecology, the American College of Obstetricians and Gynecologists continue to recommend that women abstain from marijuana use during pregnancy and breastfeeding.

The update reflects a change in the language within the opinion as well as the addition of recent research focused on marijuana use, perinatal mortality, low birth weight, and preterm birth.

The guidelines explain that the current evidence does not find strong associations between marijuana use during pregnancy and perinatal mortality or low birth weight. In a study that did not adjust for concomitant tobacco use, however, the rate of stillbirths was modestly higher in marijuana users. Furthermore, when marijuana use was stratified by frequency, women who used marijuana at least weekly had a higher risk for having a baby with low birth weight.

There is also some evidence that frequent marijuana use is associated with preterm birth, but this correlation may be tied to concomitant tobacco use.

The guidelines were updated to suggest that clinicians should inform patients about the reasons for marijuana screening (ie, to allow treatment of substance abuse and not for punishment) as well as the potential consequences of a positive screening result.

The guidelines concluded that “because of concerns regarding impaired neurodevelopment, as well as maternal and fetal exposure to the adverse effects of smoking, women who are pregnant or contemplating pregnancy should be encouraged to discontinue marijuana use.... High-quality studies regarding the effects of marijuana and other cannabis products on pregnancy and lactation are needed.”

Reference

Committee on Obstetric Practice. Committee opinion no. 722: marijuana use during pregnancy and lactation. Obstet Gynecol. 2017;130:e205-e209.

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