Review of the effects of cannabis usage on foetal outcomes, pregnancy, and reproductive health


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.

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