The Use of Cannabis and Cannabinoid-based Products by Pregnant Women: A Patent Review

Reasons pregnant people use cannabis to self-treat health conditions during pregnancy: Results from a US population-based survey

INTRODUCTION

Little is known about reasons pregnant people self-treat health conditions and pregnancy-related symptoms with cannabis.

METHODS

We administered a cross-sectional survey to 3571 pregnant and recently pregnant people from US population-based panels. Participants who used cannabis at some point during pregnancy were asked which health conditions or symptoms they used cannabis to treat and reasons they used cannabis for self-treatment. We explored differences in reasons for self-treatment by sociodemographics.

RESULTS

Nine-hundred forty-six participants indicated they used cannabis during pregnancy. Fifty-seven percent (n = 578) of those who used cannabis during pregnancy indicated they used cannabis exclusively for health purposes; 39% (n = 347) indicated they used cannabis for health and recreation. The most common reasons for self-treatment were believing cannabis was safer and more effective than other medications or treatments. Some participants reported not having health insurance or a health care provider as reasons for self-treatment. Black and Hispanic people, and people with household income under $25,000, were more likely than White people and people with household income between $25,000-$49,999 to report barriers to other medications or treatments as reasons for self-treatment. People with high school education were more likely than people with more education to report viewing cannabis as safe and effective for self-treatment.

DISCUSSION AND CONCLUSIONS

Most pregnant people self-treating health conditions or symptoms with cannabis are doing so because they consider it safer and more effective than other medications or treatments. Some people, particularly people of colour and low-income people, may also self-treat because they face barriers to other treatments.

Cannabidiol impairs neural tube closure in mouse whole embryo culture

BACKGROUND

Cannabidiol (CBD) is a nonpsychoactive constituent of cannabis widely available as a dietary supplement. Previous reports that it impairs the retinoid, sonic hedgehog, and folate metabolism pathways raise concern that it may impair closure of the embryonic neural tube (NT), producing NT defects including spina bifida and exencephaly.

METHODS

We undertook teratogenicity testing of CBD in mouse whole embryo culture.

RESULTS

At concentrations that do not diminish embryo viability, growth, or axial rotation, CBD dose-dependently impairs cranial NT closure, increasing the proportion of embryos that develop exencephaly. It concomitantly diminishes closure of the spinal NT, the posterior neuropore (PNP), producing longer neuropores at the end of culture which is a hallmark of spina bifida risk. Exposure to CBD does not disrupt the formation of long F-actin cables in surface ectoderm cells flanking the PNP or folding of the neuroepithelium at predictable hinge points. At the cellular level, CBD exposure does not alter proliferation or apoptosis of the spinal neuroepithelium.

DISCUSSION

Thus, CBD acts selectively as a neuroteratogen predisposing to spina bifida and exencephaly in mouse whole embryo culture at exposure levels not associated with overt toxicity. Large-scale testing of CBD's effects on NT closure, particularly in at-risk groups, is warranted to inform its marketing to women of childbearing age.