Review
of the effects of cannabis usage on foetal outcomes, pregnancy, and
reproductive health
The most commonly used
drug in the United States is cannabis, which is illegal under federal law (US).
Worldwide usage is rising in part as a result of legalisation in some areas and
rising accessibility and societal acceptance. Cannabis use has been rising,
especially among people who are fertile. Increasing tension and worry during
the coronavirus disease 2019 (COVID-19) pandemic may in part be to blame for
the increased cannabis use.
The biological effects of
cannabis are mediated through the endocannabinoid system. As early as the fifth
gestational week, endocannabinoid receptor expression has been seen in
developing babies. It has been discovered that the placenta, sperms, and male
and female reproductive tracts all have cannabinoid receptors, suggesting that
the endocannabinoid system may control reproduction. Breastmilk has been found
to contain delta-9-tetrahydrocannabinol (THC), the main psychoactive component
of cannabis and that could cross the placenta.
Additionally, there is
little research on cannabis' safety, particularly with reference to pregnancy
and reproductive health. As a result, approximately 70% of US women think that
using marijuana once or twice a week is harmless. The effects of cannabis on
reproductive health and the developmental consequences of offspring must be
studied in light of the rise in cannabis use.
·
Pharmacology of cannabinoids
THC and cannabidiol are
the most well-known of the more than 80 bioactive chemical compounds found in
cannabis, which is a member of the Cannabaceae family. Both the peripheral
tissues and the central nervous system express cannabinoid receptors (CB1 and
CB2). Muscle relaxation, analgesia, anti-inflammation, immunosuppression,
sedative, mood enhancement, anti-emesis, and appetite stimulation are just a
few of the medicinal effects of cannabis. However, cannabinoids are not
permitted for therapeutic use.
·
Usage of marijuana and legalisation
The most popular method
for consuming cannabis is smoking, followed by edibles. About 10% of frequent
users and 50% of chronic users develop cannabis use disorder (CUD). There are
just a few treatment options for CUD, including a combination of psychosocial
intervention, motivational enhancement therapy, and cognitive behavioural
therapy. Cannabis use is now legal in some parts of Australia, America, Africa,
and Europe.
Cannabis use has
considerably increased as a result of recreational marijuana being legalised.
In the US, recreational cannabis use became legal in 18 states in 2021. The use
of cannabis by children and adolescents would probably be affected by these
legal developments. The puberty and mental health of children may be affected
by cannabis usage, according to some theories.
·
Male cannabis uses and its effects on
fathers
Men who use cannabis
regularly report minimal to no changes in their follicle-stimulating hormone
(FSH) levels or inferior semen characteristics as a result of their use.
According to animal research, exposure to THC may have negative effects on
spermatogenesis, gonadotropin levels, sperm morphology, and testicular atrophy.
One recent study showed
that deoxyribonucleic acid's methylation was changed after exposure to cannabis
in both rats and people (DNA). Cancers and early development, especially
neurodevelopment, were linked to the effected genes.
·
Effects of cannabis use on foetal
outcomes, pregnancy, lactation, and women's reproductive health
According to a number of
studies, cannabis may have an impact on women's reproductive health processes
such ovulation, LH and FSH secretion, and menstrual cyclicity. Studies on mice
demonstrated that the treatment of acute THC reduced the levels of prolactin,
FSH, and LH. Pregnant women who use cannabis frequently also take other drugs,
which can have a synergistic or cumulative effect.
Furthermore, half of
pregnant women who use cannabis do so throughout the entire pregnancy. Growing
worries about harmful prenatal/neonatal effects arise from the possibility that
THC may bind to cannabinoid receptors in the embryonic brain or placenta.
Despite being higher, the risk of miscarriage and stillbirth varies between
research. According to some research, there may be an increased risk of newborn
fatalities, placenta abruption, small for gestational age (SGA), and NICU
hospitalizations.
THC has been found to
inhibit cytotrophoblast fusion and biochemical differentiation in vitro.
Additionally, THC prevents the amnion's epithelial layer from migrating, which
affects the growth of the amnion throughout pregnancy and increases the risk of
complications, such as preterm labour. Children in preschool who were born to
moms who used THC during pregnancy have been noted to have attention deficit,
hyperactivity, impulsivity, improper verbal and visual reasoning, and other
behavioural issues.
Within two months of
giving birth, breastfeeding mothers are likely to increase their cannabis use.
This raises questions regarding the THC that is passed through breastmilk to
the offspring gradually releasing from lipid-filled tissues. Additionally,
compared to plasma, breastmilk had a THC content that was more than eight times
higher due to chronic cannabis use. Within a month of birth, THC exposure in
newborns has been documented to have reduced motor development.
Cannabis use is
expanding, but there are few studies on its safety, particularly with regard to
reproductive health. The fact that 70% of females think its intake is safe
during pregnancy raises serious concerns because the most recent research
reveals that its use has substantial health consequences. Notably, only 50% of
the medical professionals advised against cannabis use during pregnancy.
Despite the paucity of safety data, it is vital that people and healthcare
professionals are aware of cannabis's potential side effects, especially prior
to conception, throughout pregnancy, and after delivery.