In the wake of data showing that marijuana use among pregnant women in the U.S. more than doubled from 2002-2017, a new Nature study suggests that babies born to mothers who use cannabis during pregnancy may be at higher risk of developing autism.
The study, conducted by the Ottawa Hospital Research Institute, looked at live birth data in Ontario, Canada from 2007-2012, and studied a total of 508,025 births. Of this group, nearly 2,200 women reported marijuana use alone (that is, no other substance) during pregnancy. The researchers found that among this group, the rate of autism was 4 per 1,000 person-years compared to 2.42 among those who were not exposed to cannabis in utero. In other words, babies born to mothers who used marijuana were 1.5 times more likely to have autism than those who did not.
The study, as many have indicated since then, does not establish a causal relationship between marijuana and autism. Furthermore, the authors are quick to note that the data are limited – missing information on which trimesters the cannabis use occurred, how often it was used and in what way it was consumed (ie edible, smoke or weapons). The small sample size, taken a year before Canada legalized marijuana, could also affect the results.
Moreover, the data lack information on the genetic components of the mothers as environmental risk factors, which researchers believe play a major role in autism.
Still, even with these limitations, the findings are helped by previous studies that have shown that marijuana has the potential to negatively affect a growing fetus. According to the Centers for Disease Control and Prevention, marijuana use during pregnancy is associated with a variety of conditions, including low birth weight, hyperactivity and inattention (experts have said more studies are needed on everything).
Further research has shown that the active chemicals in cannabis can cross the placental wall and affect the brain development of a fetus. In 2016, the American Academy of Pediatrics (AAP) published a specific report on marijuana use during pregnancy, detailing the available evidence and concluding that, given all these concerns, it was unsafe.
Seeing this says Dr. Seth Ammerman, one of the co-authors of the AAP report, said the findings from Ottawa are not necessarily surprising. “The main line is that there is only limited evidence, but the limited evidence is that marijuana use during pregnancy seems to have the potential to cause problems with abnormal development – not only in childhood, but potentially in childhood, adolescence and even young adults, “Ammerman, an adult and addiction medicine specialist and retired Stanford University professor, tells Yahoo Life.” The recommendations are to not use marijuana during pregnancy. “
While there is existing evidence that cannabis can lead to developmental problems, Margaret Daniele Fallin, a professor at Johns Hopkins University and director of the JHU’s Wendy Complaint Center for Autism and Developmental Disabilities, asks caution in drawing conclusions. “Marijuana use in pregnancy has not been extensively studied as a risk factor for autism,” Fallin told Yahoo Life. “Prenatal exposure to substances is a plausible risk factor for neurodevelopmental problems, so it is important to continue with these and related questions … This study is a good early step. However, since it is not a randomized controlled trial (which probably would not be ethically reasonable), we need to build a body of research on multiple well-designed and implemented studies to draw conclusions about marijuana during pregnancy and the risk of autism in infants. ”
Ammerman agrees that more research is needed, but suggests that marijuana use during pregnancy could be viewed through the lens of another drug. “It’s probably similar to alcohol – but again very limited evidence – while the first trimester would be the most problematic, second trimester a little less and the third trimester a little less than second than first, simply because of fetal development and how that works, “Ammerman says. “But your first trimester when everything really starts to develop, when you visualize cannabis and develop the fetal brain, you bring in all these external cannabinoids … we really want to limit an external exposure to that developing brain.”
However, he notes that there can be a variety of “confusing variables” that may not be related to marijuana, but can make the situation worse on their own. “Sometimes when we look at the studies, there could be another substance use, which can be problematic,” says Ammerman. “Or it may be prenatal care that is not regular, especially for underage populations.”
Dr. Darine El-Chaâr, a mother-fetal medicine doctor at Ottawa Hospital and one of the authors of the study, says many are ashamed of the conclusion. “There have been people who are ridiculous about the results … and listen, it’s still a weird topic,” El-Chaâr told Yahoo Life. ‘So what I’m saying is, I’m not here to judge or stigmatize anyone who uses cannabis. Women who use cannabis usually have a reason for it. And we try to work together to change that as much as possible. ”
As a practicing physician, talking to women about cannabis use during pregnancy is what El-Chaâr regularly does. And while she sympathizes with those who use it, she says there are other, safer methods available. “What I’m telling my patients is that just because it’s legal and a natural substance does not mean it’s safe, does it?” El-Chaâr says. “There are other substances in pregnancy that are illegal and from natural sources – such as alcohol – that are not safe during pregnancy. To date, the data indicate that there is placental transmission and that it affects the brain. So if you find that it helps with morning sickness, we can find other medications that can help. But at the moment we advise to change the treatment because we have no better proof that it is safe. “
Fallin adds that the study, although important in “provoking further research,” should not be used to convict pregnant women. “I worry that we as a society are putting a lot of pressure on women during pregnancy to ‘do this,’ but ‘not do that,'” Fallin says. “It can be confusing and frightening for women. A critical message is for women to take care of mental and physical well-being. Stay informed, try to minimize risk, while also not being afraid of any activity and decision. ”
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