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Jennifer began roughly starting her pregnancy. "I had really intense food aversion and really nausea," says the 28-year-old mother of a five-month-old girl. "I didn't eat at all."
She was losing weight instead of gaining weight, she says, and couldn't even hold the prenatal vitamins or iron pills that had to deal with anemia. (NPR uses only its first name to protect its privacy.)
And with her first prenatal appointment still weeks away, she began to worry that she wasn't getting enough nutrients to support her pregnancy. "Basically, I was in a space where I felt like I wanted to be a new mom and take care of my baby and I couldn't make it," Jennifer says.
Then her husband bought her ice tea with CBD and THC, two of the main components in cannabis. "I've never actually been a marijuana user," she says. "I don't mind, but I just don't care about it."
But that day she took a few sips of the drink. She said that her nausea was gone and she was able to eat her first full meal in days. She continued to take a few sips here and there over the next few weeks when she failed to eat.
Jennifer is among more than 100 women who wrote to NPR about cannabis use during pregnancy. Most of them use it for extreme nausea, vomiting and weight loss, so bad in some cases that they had to be hospitalized.
Studies show that more pregnant women in the United States are using the drug. And those with severe nausea and vomiting are more likely.
But recently, the Food and Drug Administration issued a statement strongly "recommending that women do not use cannabis in any form – including CBD – in pregnancy or breastfeeding because it could pose" serious risks. "
The FDA cited a study showing that THC, the main psychoactive component of cannabis, crosses the placenta and can affect fetal brain development, and there is evidence that it can be transmitted through breast milk. exposure to
Over the years, research on the subject has had conflicting results, says Dr. Tori Mets, an associate professor of obstetrics and gynecology at Utah University who studies marijuana use during pregnancy. " results that say marijuana has no effect on pregnancy outcomes and you can find other studies that say it's happening, "she says.
However, research indicates some serious concerns. While early studies linking cannabis use for preterm birth and low birth weight were not explicit, more recent work has shown a link. Early studies had some confusing factors, explains Daniel Corsi, an epidemiologist at the Ottawa Hospital Research Institute. Women who use cannabis during pregnancy also tend to be younger and use substances such as tobacco, alcohol, and other drugs, all of which can cause adverse birth outcomes.
But Corsi and his colleagues recently published a study that addresses those that are confusing. They examined data on more than 600,000 pregnancies and births at an Ontario hospital between 2012 and 2017. About 1.4% of these women used cannabis during pregnancy.
Researchers compared women who used cannabis with those who did not and who were of similar age, socio-economic background, and similar use of alcohol and tobacco. They found that while women who did not use cannabis had a premature birth rate of 6.1%, the rate of premature birth for women who used the drug during pregnancy was 12%.
Thus, while the overall risk of prematurity among women who use cannabis was moderate, it was twice as high as for women who did not use cannabis.
The Mets say researchers still don't have to reduce the frequency of use or concentration of the drug when the adverse effects begin. But, she says, "there is definitely no degree of use that anyone could say was safe."
And there is some evidence that prenatal cannabis exposure can have a longer-term effect on fetal development.
"My concern about marijuana use during pregnancy is that it will interfere with the development of the brain during pregnancy," says Nora Volkov, director of the National Institute on Drug Abuse. vulnerability. "
She says studies done in laboratory animals suggest that prenatal cannabis exposure can alter the brain of the fetus. It affects the development of the prefrontal cortex, which is crucial for decision making and affects parts of the the brain involved in our sensitivity to rewards.
However, it may be difficult to translate findings from animal studies into humans, she acknowledges. For example, the levels of cannabis exposed to laboratory animals may not be consistent with exposures in Real Life in Pregnant Women
And when it comes to understanding the real risks, there are still gaps in research, such as how much marijuana is used by pregnant women? "In fact, we don't have good measures about the type of exposure some of these pregnant women are exposed to," Volkov says.
The levels of THC and CBD in different products vary widely and women may differ in the product they use and how often.
What further complicates the picture is that research on cannabis and its effects on health is limited, as it is still classified as a Schedule1 drug federal, Volkov notes.
One thing that concerns researchers and the public health officials is that the cannabis market is growing rapidly with little regulation.
"Who monitors the quality control of these products in many of the countries that sell them?" Asks Volkov. "In many cases, there was a big discrepancy between what the product claims to provide to the customer and what it actually contains."
The FDA Council cites reports of contamination of CBD products with THC, pesticides, heavy metals, bacteria and fungi.
With all these unanswered questions, "we know enough to say we should be cautious," Volkov notes. "Why Take the Risk?"
For the Mets, when she consults her own patients, she discusses them through the available data. "After all, it's always a woman's choice of what to do with her body and during pregnancy," Mets says. "But I think we should at least provide counseling so that they can make an informed decision."
Jennifer remembers worrying that the drug may affect the health and development of the baby. She wanted to know more, so she looked at children's development books that had no information about cannabis. She also looked online, but couldn't find anything convincing.
"I was disappointed that I couldn't actually find the information," she says.
Still, she was cautious about the risk when she started using cannabis in her first trimester, using only a small amount of it.
"In the end, I came to the conclusion that malnutrition is much worse than the little marijuana I consume," she says.
And as soon as her nausea was gone, she stopped.