Serious maternal complications linked with use of marijuana, study says

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25 Jul 2024, 20:21

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More and more people are using marijuana before or during pregnancy to ease nausea, pain, stress and help with sleep. In fact, research found that use has more than doubled in the last two decades.

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Marijuana use in pregnancy has been linked to such adverse outcomes for the baby as lower birthweight, preterm birth and higher admission rates to neonatal intensive care units.

What about the potential danger to the mother if she uses cannabis before or during early pregnancy? According to a new study, the news there is alarming as well. There's an increased risk of serious, potentially life-threatening maternal complications such as gestational hypertension and preeclampsia, which are both disorders of high blood pressure.

'Pregnant individuals who used versus did not use cannabis during early pregnancy had a 17% greater risk of gestational hypertension (and) an 8% greater risk of preeclampsia,' said lead study author Kelly Young-Wolff, a research scientist at Kaiser Permanente Division of Research in Pleasanton, California.

People who used marijuana in early pregnancy also had a '19% greater risk of placental abruption,' Young-Wolff said.

In placental abruption, the organ that provides oxygen and nutrients to the fetus, called the placenta, suddenly detaches from the side of the uterus, thus endangering the health of the mother and the developing baby. A detached placenta is one of the leading causes of death in both expectant mothers and babies.

'Research suggests that pregnant people are bombarded with inaccurate messages from social media, cannabis retailers and peers suggesting that cannabis use during pregnancy is safe,' Young-Wolff said. 'Our study provides timely and important data that adds to the growing body of evidence indicating that cannabis use during pregnancy is not safe.'

A DEA officer stands next to packages of marijuana and cocaine during an offload at Port Everglades, in Fort Lauderdale, Florida on November 22, 2021. The US Coast Guard offloaded millions of dollars of drugs which were intercepted at sea at Port Everglades on Monday morning.

Compared to weight gain considered optimal for a successful pregnancy, people who used marijuana before or during early pregnancy were more 9% more likely to gain too much weight and 5% more likely to not gain enough weight during their pregnancies, the study found.

This is the largest study to date looking at cannabis use in pregnancy and adverse health outcomes in the mother,' said Brianna Moore, an assistant professor at the Colorado School of Public Health in Aurora, Colorado, in an email. Moore, who studies the use of cannabis in pregnancy, was not involved in the new research.

'It is never too late to cut back or limit your use of cannabis in pregnancy to minimize the potential health effects,' Moore said. 'Talk to your healthcare provider.'

Serious, even life-threatening complications
Gestational hypertension is diagnosed when an expectant mother's blood pressure rises above 140/90 after the first 20 weeks of pregnancy, typically receding back to normal after birth. Consistent high blood pressure during pregnancy can 'hinder blood flow in many different organ systems in the expectant mother including the liver, kidneys, brain, uterus, and placenta,' according to the Children's Hospital of Philadelphia.

For some women, gestational hypertension can develop into preeclampsia, a more serious form of high blood pressure in which increased blood levels of liver enzymes and protein in the urine are signs of possible kidney or liver damage in the mother. Blood platelet levels can decrease, and fluid can build up in the lungs, causing shortness of breath, according to the Mayo Clinic.

Why replacing alcohol with weed is a growing trend in the US
In extreme cases, such high blood pressure can lead to blood clots, seizures, stroke, temporary kidney failure and liver complications, according to the Cleveland Clinic.

'Preeclampsia can also lead to preterm delivery and admission in the neonatal intensive care unit, which separates the mom and baby at the time of birth and can interfere with that initial ability to bond skin-to-skin,' said OB/Gyn Dr. Deborah Ansley, medical director for the Kaiser Permanente Early Start prenatal health program in Northern California, in an email.

How does marijuana cause such serious consequences during pregnancy? Experts believe that cannabinoids, including tetrahydrocannabinol, or THC, may bind to receptors in the placenta, disrupting estrogen signaling and affecting placental development and function.

THC is the part of the cannabis plant that creates euphoria, but more than 100 other cannabinoids have been identified in the cannabis plant, along with more than 500 other chemical substances.

Dangers highest with daily use
The study, published Monday in the journal JAMA Internal Medicine, used health data from Kaiser Permanente Northern California, which provides health care to 4.6 million people. More than 250,000 pregnant people were asked about their marijuana use when they entered into prenatal care at approximately 8 to 10 week’s gestation. Many of those patients also underwent urine analysis that could detect any marijuana use for the past 30 days.

More than 20,000 were identified as cannabis users — including nearly 11,000 expectant mothers who did not admit to marijuana use but tested positive by urinalysis.

'Our study was unique in that we had a large enough sample size to conduct a sensitivity analysis that limited the sample to pregnant patients who did not screen positive for any other substances,' Young-Wolff said.

'Importantly, results from this analysis followed the same general pattern as the main findings, indicating that our findings were not attributable to the use of other substances during pregnancy,' she said.

The likelihood of developing gestational hypertension rose with the frequency of use, with daily users having the most risk.

'Our prior work has shown that the frequency of prenatal cannabis use is increasing over time, with a greater proportion of those who use cannabis during pregnancy reporting daily use in recent years,' Young-Wolff said.

That's especially worrisome as the potency of marijuana today is much greater than in the recent past, experts say.

Being pregnant is hard work — even metabolically, study shows
Using at least once a month or more was linked to a greater risk of placental abruption, the study found. In addition, there was an increased risk of eclampsia, a more serious form of preeclampsia that can lead to seizures and death, but the risk was not statistically significant, according to the study.

There was one unusual finding: a reduced risk for gestational diabetes. Studies in non-pregnant adults have been mixed about the impact of marijuana on insulin resistance and metabolic syndrome, a mix of health issues that can lead to diabetes and other chronic diseases, Moore said.

'More studies are needed to understand whether and how cannabis use in pregnancy may impact risk for gestational diabetes,' Moore said.

Discuss marijuana use with physicians
The study has limitations, the authors acknowledge. For one, they were not able to determine if marijuana use continued during the pregnancy.

'My suspicion is that the health effects would be stronger if the pregnant person continued to use cannabis after the first trimester, but more studies are needed,' Moore said.

A cloud of smoke rises over people smoking as a clock hits 4:20pm while musician Lil Jon performs during the Mile High 420 Festival in Denver, Colorado, on April 20, 2022, known by some as 'Weed Day'. Tens of thousands of cannabis enthusiasts gathered in Denver on April 20 to celebrate the ever-widening US legalization of recreational weed with plumes of pungent smoke, music... and a few grumblings about commercialization. April 20 has become the national holiday for the herb in the United States, as the date corresponds with the "420" slang name for marijuana.

Urine tests could only look for THC and no other cannabinoids, and the self-report could not determine if use was due to smoking or edibles, Young-Wolff said. In addition, since all of the expectant mothers were based in northern California, a state which legalized medicinal cannabis in 1996 and adult use sales in 2018, the results may not be generalizable to other populations in the United States.

The results may also not be applicable to the general population since 'the participants in this study were older, had higher incomes, and almost all had private health insurance,' Moore added.

As the known health risks for marijuana grow, pregnant women should feel free to discuss any cannabis use with their health care provider without fear of reprisal, experts say.

'If pregnant individuals are considering using cannabis during pregnancy to self-medicate pregnancy-related symptoms, we encourage them to discuss those symptoms with their doctor and use interventions recommended by clinical practice guidelines,' Young-Wolff said. 'If pregnant individuals are not willing to quit using cannabis, we recommend that they try to use it less frequently.'

Source: CNN

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According to the Bangladesh Endocrine Society (BES) currently, about 1.31 crore people are suffering from diabetes in the country making it eighth in the world. World Diabetes Day reminds us of the growing impact of diabetes on global health and the urgent need for collective action to prevent, diagnose, and manage this chronic condition. In 2024, the theme 'Breaking Barriers, Bridging Gaps' underscores the critical importance of accessible, high-quality diabetes care, especially for underrepresented communities. The Government of India’s initiatives reflect a proactive, multi-faceted approach to diabetes prevention through enhanced healthcare access, awareness programs, and lifestyle promotion programs. By fostering awareness, providing resources, and encouraging healthy living, these initiatives aim to reduce the prevalence of diabetes and alleviate its long-term complications, contributing to a healthier future for all citizens.

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Over time, this can make cravings stronger, as the brain becomes wired to seek out certain foods for the reward they provide. Stress, emotional states, hormonal fluctuations, and even nutritional deficiencies can further trigger these cravings. Additionally, Dr Sarthak Dave, an Ahmedabad-based psychiatrist, explains that food cravings driven by the brain's dopamine mechanism can be gustatory (taste-related), visual (triggered by food imagery), or olfactory (stimulated by smell). Gustatory cravings are rooted in the memory of past taste experiences. Visual cravings are influenced by appealing food presentations, especially prevalent on social media. Olfactory cravings are sparked by the aroma of food, which can evoke strong memories and desires, often making us crave a specific dish even without seeing it. Meanwhile, Dr. Bhavna Garg, senior consultant - dietitian, and nutritionist, Yashoda Super Speciality Hospital, NCR, mentions that food cravings are extremely common, with more than 90 percent of people experiencing them. "Every person experiences cravings differently, but they are typically transient and often for processed foods that are high in sugar, salt, and unhealthy fats. Research suggests that males are more likely to crave savory foods, whereas females are more likely to crave high-fat, sweet foods," she adds. Cravings and mental health According to Dr Dave, food cravings can reveal a lot about a person's mental health. He says, "Sometimes, having food cravings may also be a sign that the individual is doing well mentally. In psychiatric conditions like depression or anxiety, food cravings often diminish because dopamine levels drop. Even when eating enjoyable food, there may be no dopamine surge, reflecting a lack of the usual pleasure response. Therefore, the presence of food cravings can indicate better mental well-being." However, food cravings can also be linked to eating disorders. Dr Dave states that in binge-eating disorder, there is an intense, sudden urge to consume large quantities of food, often followed by voluntary purging. This creates a vicious cycle of overeating and purging. Additionally, food cravings may contribute to obesity through emotional eating, where individuals eat to cope with negative emotions. In these cases, eating temporarily boosts dopamine, but once the effect wears off, feelings of guilt and distress return, perpetuating the cycle as the person believes it's the only way to feel better. On the other hand, Dr Rajiv Mehta, vice chairperson, of psychiatry, Sir Ganga Ram Hospital, Delhi, feels that the mental health of a person impacts their cravings. For example, during a stressful situation, people show a preference for sweetened foods like chocolates and fried snacks. Dr Mehta says that when food cravings become overwhelming, a person may overeat, leading to potential weight gain. This can trigger mental health challenges, including obsessive body focus, body shaming, body dysmorphia, and, over time, even anxiety and depression. To this, Dr Jaiman adds that relying on food for comfort can lead to guilt, shame, and lowered self-esteem. Should you indulge? Dr Mehta states that if you constantly ignore your food cravings, it means you have self-control and recognize that food isn't the best way to manage stress. However, indulgence suggests that you may not have found any other effective coping mechanisms for stress. He explains that food cravings are one of the signs that mental health is being impacted. If cravings occur only occasionally, indulging is harmless; however, if cravings are frequent, it’s essential to look for other symptoms of stress, anxiety, and depression. Meanwhile, Dr. Dave emphasizes the importance of finding a middle ground between giving in to cravings and knowing when to hold back. If you always give in, it can lead to overeating, guilt, and potential harm to overall health. The key is recognizing whether a craving is driven by real hunger, emotions, or external influences. Ignoring cravings entirely can lead to feelings of deprivation, increasing the risk of binge-eating later. By being aware and understanding what your body truly needs, you can make healthier choices. Controlling your cravings Dr Bhavna Garg shares some easy tips that can help you control food cravings: Eat a balanced diet with a variety of foods, including proteins, healthy fats, fiber, and complex carbs. Doing so helps keep blood sugar levels stable and reduces sudden cravings. Sometimes we're just thirsty, not hungry. Thirst is often mistaken for hunger, so drinking water can curb cravings. Distract yourself with activities or chew gum. Engaging in an activity, like going for a walk or doing a quick chore, can help shift your focus away from cravings. Plan consistent meals in advance. Having regular meals prevents extreme hunger and reduces impulsive snacking. Get enough sleep to maintain hormonal balance. Poor sleep disrupts hormones like ghrelin (the hunger hormone) and leptin (the satiety hormone), which can lead to increased cravings. Stress can trigger cravings, so engaging in stress-relieving practices like meditation or exercise reduces cortisol levels, helping control cravings.