XXXX use in pregnancy and lactation: a review of the evidence.

@entity1 @entity286 @entity839 @entity2209 @entity600 @entity835 @entity2915
UNASSIGNED: With the legalization of recreational marijuana in many states, we anticipate more @entity1 will be using and self-reporting marijuana use in pregnancy. @entity835 is the most common illicit drug used in pregnancy, with a prevalence of use ranging from 3% to 30% in various populations. @entity835 freely crosses the placenta and is found in breast milk. It may have adverse effects on both perinatal outcomes and fetal neurodevelopment. Specifically, marijuana may be associated with fetal growth restriction, @entity2209 , and @entity600 . However, data are far from uniform regarding adverse perinatal outcomes. Existing studies are plagued by confounding by @entity286 and other drug exposures as well as sociodemographic factors. In addition, there is a lack of quantification of marijuana exposure by the trimester of use and a lack of corroboration of maternal self-report with biological sampling, which contributes to the heterogeneity of study results. There is an emerging body of evidence indicating that marijuana may cause problems with neurological development, resulting in @entity2915 , poor cognitive function, and changes in dopaminergic receptors. In addition, contemporary marijuana products have higher quantities of @entity839 than in the 1980s when much of the marijuana research was completed. The effects on the pregnancy and fetus may therefore be different than those previously seen. Further research is needed to provide evidence-based counseling of @entity1 regarding the anticipated outcomes of marijuana use in pregnancy. In the meantime, @entity1 should be advised not to use marijuana in pregnancy or while lactating.
