Study: Many pregnant women uncertain of marijuana risks even as use increases

Press release from UF Health

BY BILL LEVESQUE

GAINESVILLE, Fla. — Many pregnant women are unsure if it’s safe to use marijuana or products containing cannabidiol, an active compound in marijuana, even as they increasingly turn to them to combat morning sickness, anxiety, or insomnia, a recent University of Florida Health study shows.

The American College of Obstetricians and Gynecologists advises against the use of marijuana and cannabidiol, or CBD, during pregnancy. Marijuana use has been associated in some studies with adverse fetal neurodevelopmental outcomes.

Evidence of cannabidiol safety is sparse in human studies, but researchers remain concerned that it might nonetheless pose a danger. CBD is not intoxicating.

The UF Health researchers said their study shows a need for the medical community to better educate women about the potential hazards to the fetus from using marijuana, also called cannabis.

One worry is that some people believe the spreading legalization of marijuana or CBD around the nation equates to the government giving its stamp of approval that the products are safe, researchers said. Medical marijuana is legal in Florida, although its recreational use is not.

“If a medication is legal, we assume that maybe it’s safe, although other things like tobacco and alcohol are also legal, and we know that those can be harmful to pregnancies,” said Kay Roussos-Ross, M.D., the study’s senior author and a professor in the UF College of Medicine’s Department of Obstetrics and Gynecology.

“We see a good deal of data out there that shows that there is increased risk of psychiatric and behavioral issues related to marijuana use in pregnancy, but we need more,” she added. “We need more so that we can be correct in our assessments and our educational efforts to women of reproductive age who are using marijuana.”

It’s difficult to quantify the rise of marijuana and CBD use during pregnancy, with most estimates showing an increase predating COVID-19. A 2021 federal survey reported 7.2% of pregnant women used marijuana. The UF Health study noted that emerging evidence from obstetrics care shows more pregnant women are trying the products, perhaps because of increased legalization.

The study, published in Medical Cannabis and Cannabinoids, surveyed 261 women and used focus groups to explore participants’ perceptions of the products. The women were either pregnant, breastfeeding, or caring for a child 5 years old or younger, and reported use of marijuana or CBD products, such as vapes, smoking, tincture oils, or ointments.

“There seems to be a disconnect,” said Amie Goodin, Ph.D., an assistant professor in the UF College of Pharmacy’s Department of Pharmaceutical Outcomes and Policy and the study’s lead author. “About one in six pregnant women are telling us, ‘Yes, I have used marijuana or a CBD product while I’m pregnant.’ But half are saying, ‘I don’t know what the risks are.’”

About 40% of the pregnant women surveyed said they were unsure how risky it was to use marijuana once or twice a week during pregnancy, compared with 34.5% of women who were not pregnant when surveyed for the study but who had children.

Asked the same question about CBD, more than 52% of pregnant women were unsure of the risk, compared with 41.8% for mothers who weren’t pregnant when surveyed.

About 36% of pregnant women reported using marijuana, compared with 65% of mothers not currently pregnant, perhaps reflecting at least some increased caution among those in the former group. CBD use was 19.9% for pregnant women and 38.2% for women who were not pregnant.

“Some women did mention that the legalization of marijuana has made marijuana more socially acceptable,” said study co-author Deepthi Varma, Ph.D., an assistant professor in the College of Public Health and Health Professions’ Department of Epidemiology.

The researchers said they were especially concerned that women were even less sure of the safety of CBD use because it is widely available and often seen as harmless.

“You might notice that it’s even something that you can buy at a gas station or a grocery store,” Goodin said. “CBD in a purified form has actually got an FDA approval to treat certain types of pediatric epilepsy on its own… but pharmaceutical-grade CBD is not quite the same thing as you would expect to get if you were purchasing CBD oil at a smoke shop or a gas station.”