Cannabis Use Disorder During the Perinatal Period

Abstract

Cannabis use among pregnant and parenting women is increasing in the USA, alongside escalating THC potency in available cannabis products and the use of synthetic preparations. Existing information on how cannabis use during pregnancy may impact the course of pregnancy and fetal/child development is limited, and studies that evaluate birth outcomes and postnatal development of prenatally exposed children are inconsistent. However, accumulating neurodevelopmental data in animals and humans shows that pre- and postnatal cannabis exposure portends harm for the developing fetus and the child. THC crosses the placental barrier, and current evidence indicates that prenatal cannabis use, especially during critical periods of brain development, places the developing child at risk for neuropsychiatric, behavioral, and substance abuse problems. The extensive legalization of cannabis, the recent increase in marijuana use by pregnant women, the availability of cannabis with higher THC concentrations, and the introduction and escalating use of synthetic cannabinoids create an urgent need to determine the effects of the amplified fetal THC exposure. The risk of neurodevelopmental problems in THC-exposed children may be enhanced if the child is raised by a mother affected by neurobehavioral dysfunctions and associated comorbidities of an active cannabis use disorder. Identification and treatment of cannabis use and cannabis use disorder in women during the perinatal period should be a high clinical priority. Misperception of risk, inadequacy of provider knowledge and training, and scarcity of time and resources to comprehensively address the needs of cannabis-exposed mother-child dyads are common among health providers. Although more research is needed to establish the perinatal effects of maternal cannabis use, pregnant and postpartum women should be aware that perinatal cannabis use risks safety for both mother and child. This chapter provides an overview of the epidemiology of perinatal cannabis use, the neurobehavioral effects of prenatal cannabis exposure for the developing child, and the treatment strategies for the mother-child dyad affected by cannabis use.