Cannabis causes birth defects
"Poison for the brain" : Does smoking weed harm the baby during pregnancy?
Smoked pure, mixed with tobacco or as a biscuit: cannabis is the most widespread illegal drug in Germany - and probably also the most tolerated. According to data from the European Drugs Report, which was presented in June (here as a PDF), more than 27 percent of Germans between the ages of 15 and 64 have already consumed cannabis.
But there is another number from the report that prompted the Federal Association of Gynecologists to issue a warning on Tuesday: Every ninth woman in Germany between the ages of 18 and 34 has smoked weed in the past twelve months. This is the age at which most women become pregnant. According to studies, two to five percent continue to use it anyway. In the USA, according to the latest figures, every 10th pregnant woman uses a joint every now and then, and quite a few do this almost daily (JAMA: Volkow et al., 2019). Although there are no exact figures in this country, the gynecologists believe that there are more than assumed. The main reason they believe is that many consider cannabis to be a harmless drug that will not harm the child. But that is wrong. "Since the unborn baby's brain is developing from day to day, cannabis, like alcohol, does not just act as a drug, but as a poison," says the president of the professional association Christian Albring.
Some women smoke weed for nausea during pregnancy
Cannabis is usually consumed as marijuana (dried flowers and leaves) or as hash (the resin of the hemp plant pressed into blocks). Cannabis contains hundreds of ingredients. When smoking, there are additional toxins that are created by burning the plants and paper and about the effects of which little or nothing is known.
The substance group of cannabinoids, above all delta-9-tetrahydrocannabinol (THC), has been better researched. This substance, which occurs in the inflorescences, is also responsible for the effects on the psyche, such as the euphoric effect.
It comes about because THC can easily cross the cell barrier between the bloodstream and the brain. There it docks to certain recipient sites (receptors) that are actually reserved for the body's own cannabinoid system. This regulates processes in the body that have to do with memory, pain or nausea.
Medical cannabis can also be used as a reserve drug for chronic pain or vomiting in the context of cancer. Especially in the USA, pregnant women also consume cannabis on their own to prevent pregnancy sickness. However, for ethical reasons, this effect has never been tested in a controlled study. A Canadian observational study recently showed that cannabis use during pregnancy means that women are less likely to develop gestational diabetes and less likely to suffer from pregnancy poisoning (preeclampsia) (JAMA: Corsi et al., 2019).
Cannabis can also be addictive, and studies suggest an increased risk of psychosis and other mental illnesses.
The problem with pregnancy is that THC not only reaches women, but also babies. This is because the substance can relatively easily cross the placental barrier, which is actually supposed to prevent harmful substances from reaching the child's circulation.
Children whose mothers smoked weed were particularly lightweight
When talking about the effects of cannabis in pregnancy, one has to distinguish those that already appear in the womb from those that start in pregnancy, but which can sometimes only be recognized years later, perhaps never. "The study situation is generally bad," says Stephanie Padberg from the Embryotox Pharmacovigilance Center at the Berlin Charité.
Malformations like alcohol are most likely not to cause THC. In a large study, however, scientists found a connection between the mother's cannabis use and reduced fetal growth in the uterus (Journal of the American Academy of Child & Adolescent Psychiatry: El Marroun et al., 2009).
Children whose mothers had been smoking weed throughout pregnancy were particularly lightweight at birth. This could be caused by cannabis receptors in the placenta, which are stimulated by THC and lead to growth inhibition (Molecular Human Reproduction: Khare et al., 2006). In the SCOPE study from Australia, where cannabis is a widely used recreational drug, researchers attributed up to twelve percent of premature births to THC contact in the womb (Reproductive Toxicology: Leemaqz et al., 2016). Another large Australian study found that children exposed to THC had to be treated in an intensive care unit more often after birth (Addiction: Burns et al., 2006). However, they did not determine any increased mortality.
THC causes small blackouts in the brain
Withdrawal symptoms, such as those that occur in newborns whose mothers used heroin during pregnancy, do not usually occur in babies of cannabis smokers. If anything, doctors find subtle abnormalities. Sometimes the children show exaggerated reflexes, cry in high tones or have a disturbed sleep rhythm. Scientists see this as a sign that cannabis use during pregnancy not only affects children's growth, but above all their brains.
There are a particularly large number of cannabinoid receptors located there, almost 90 percent of the cells have such docking points. They are created very early - and are extremely important for the networking of nerve cells. They react accordingly sensitively when they are disturbed. "The processes involved in brain development can be imagined as in a telephone switchboard," explains Tibor Harkany from the Medical University of Vienna.
According to the neuroscientist, every cell in the brain is connected to 40,000 others. As the brain develops, cells would learn which of the incoming information is important to them and which to ignore. "THC intervenes in this process and causes small power outages in the telephone exchanges."
According to Harkany, they can last up to 48 hours. In the worst case, "emergency calls" would be set to a low level and unimportant background noise would be loud. The brain remembers this wrong pattern - for the rest of life.
The neuroscientist is convinced that these effects will later affect learning and the psyche of children. Researchers from the Netherlands also wanted to detect changes in humans, which he examined primarily in animal models.
Using magnetic resonance examinations, they were able to show that the brain structure of six to eight-year-old children whose mothers consumed cannabis during pregnancy looked different than that of non-exposed children: in particular, the anterior parts of the cerebral cortex were thickened (Biological Psychiatry: El Marroun et al ., 2016). There, in the prefrontal cortex, processes are controlled that are important for attention, self-control and working memory.
Can the children remember things worse later?
But what does that mean for the children? Does cannabis use during pregnancy really affect whether a child is less alert later on or is less able to remember things? Some observational studies establish such a link.
In the first few years, the children are initially inconspicuous. But that changes from school age onwards. In examinations, some of them then performed worse in language and memory tests and were more inattentive than their schoolmates who were not exposed to the drug in the womb.
Studies have shown that some changes can persist beyond childhood into puberty, including impulse control disorders, childhood depression, addictive behavior, and later crime. According to Harkany, some effects can be explained by the fact that there are particularly many cannabis receptors in areas of the brain that have to do with reward, addiction and motor control.
Cannabis is not responsible for everything
However, all of these studies have one problem: they cannot determine exactly what part of the changes in children cannabis has. "Often times, women who use cannabis a lot and regularly also take other drugs such as alcohol and tobacco," says Stephanie Padberg of Embryotox. Poor prenatal care and difficult social situations could also affect children's development. Therefore, according to the doctor, one has to be careful when interpreting the results.
Presumably, the effects on the child also depend on the amount of intoxicant consumed. So it probably makes a difference whether someone smokes a joint once in the fifth week or smokes weed every day. That cannabis is just as toxic to the child as alcohol - drinking during pregnancy is the most common cause of intellectual disability - is in any case unlikely.
"Ultimately, we have so far not had any evidence that cannabis is highly toxic to the unborn child, but also none to give the all-clear," says Padberg. Therefore, in their opinion, women should be clearly advised against continuing to consume during pregnancy and breastfeeding - whether once or regularly.
If you can't get rid of the drug on your own, you should urgently seek professional help from counseling centers or the gynecologist. Padberg says: "Cannabis has no place in pregnancy."
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