Marijuana: ACOG Encourages Abstinence While Pregnant or Breast-Feeding

June 22, 2015

Marijuana: ACOG Encourages Abstinence While Pregnant or Breast-Feeding

  1. Allison Bryant, MD, MPH

ACOG discourages use of marijuana during pregnancy or lactation, even for medicinal purposes.

  1. Allison Bryant, MD, MPH

Marijuana is the most common illicit substance used by pregnant women, with prevalence as high as 30% in some communities. With the advent of marijuana's legalization in several U.S. states, the American College of Obstetricians and Gynecologists (ACOG) has published its position on use of this agent during pregnancy and breast-feeding.

While ACOG's Committee on Obstetric Practice acknowledges the limitations of available data about marijuana's effects on the fetus during pregnancy and on the neonate during lactation, it advises discontinuation of maternal use, whether recreational or medicinal. Animal studies suggest alterations of fetal brain development. While human studies do not implicate marijuana as a cause of structural fetal abnormalities, use during pregnancy has been associated with lower scores on tests of attention, coordination, and behavior in offspring. Although this may be partially explained by greater likelihood of polysubstance abuse or unhealthy lifestyles among women who use marijuana, the recommendation for abstinence stands.

Comment

Marijuana use during pregnancy is often thought to be benign, particularly in this era of increasingly permissive attitudes and laws. ACOG is to be commended for its stance that clinicians should discourage marijuana use and inform women of the potential consequences, while continuing to screen, refer, and treat women for tobacco, alcohol, and illicit substance use and abuse in a nonjudgmental fashion. Pregnancy often provides a “teachable moment” that — with support — allows women to make meaningful lifestyle changes that will benefit their health beyond the 9 months of gestation.

Editor Disclosures at Time of Publication

  • Disclosures for Allison Bryant, MD, MPH at time of publication Nothing to disclose

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