Cannabis Usage and Patient Perception: Assessing Risks Versus Benefits during Pregnancy and the Six-Month Postpartum Period

Abstract

Research Question: What are the perceptions of the risks and benefits of Cannabis use during pregnancy of patients who are pregnant or in the six-month postpartum period with a social history of cannabis usage? Furthermore, do these perceptions differ from patients’ perspectives of cannabis usage in general? How do these patients believe pregnancy is impacted by cannabis usage?

Background, Significance, and Rationale: Marijuana, ¿9 - tetrahydrocannabinol (THC), is one of the most commonly used illicit drugs in the United States. Since 1996, 33 states have passed Medical Marijuana Laws including 11 states that have passed recreational marijuana laws. While the increased usage of medical marijuana and recreational marijuana is correlated with increased acceptance and accessibility, the American College of Obstetricians and Gynecologists state that women should not use cannabis during preconception, pregnancy, and lactation. This recommendation is due to the main psychoactive component of cannabis crossing the placenta during gestation. In the midst of this recognition, the prevalence of current cannabis use during and after pregnancy has increased. This increase can be seen across a spectrum of factors including socioeconomic status, age, race, etc. However, less has been published regarding patient perceptions on risks and benefits of cannabis use during pregnancy and the clinical understanding of cannabis’ effects during pregnancy and lactation. This study aims to elucidate what these perceptions may entail by surveying the previously or presently pregnant and six-month postpartum patients.

Materials and Methods: A cross sectional cohort study of previously or current pregnant and six-month postpartum patients were recruited for a survey. After creating a cross-sectional and comprehensive examination survey on usage of cannabis, the survey was distributed to John Peter Smith (JPS) Women’s Health clinic. Before the administration of the survey, an introductory document explained the details of how the survey should be conducted in a professional manner. The patients at the medical clinic were offered to participate in the study’s survey and given an appropriate consent and liability form. We used a qualitative description methodology to capture patients’ perspectives on the risks and benefits of cannabis usage in the prenatal and six-month postpartum period.

Results: We anticipated that prenatal and six-month postpartum patients with a social history of cannabis usage would demonstrate survey responses consistent with the ideology that benefits of cannabis usage outweighs the risks. We expected this response due to the lack of evidence-based medicine on detrimental effects imposed on the fetus with cannabis usage during pregnancy. Furthermore, we demonstrated participants reporting cannabis use were more likely to be young, single, Hispanic or Black/African American females with an income less than $50,000. 30% participants report smoking marijuana 2-3 times per month (n=12). Participants were also asked if they believed there was harm in marijuana use during pregnancy or while breastfeeding and 55% (n=22) reported no or they did not know (m=1.98, std deviation 1.055). 55% (n=22) of the participants did not believe their health care providers did a good job in addressing marijuana usage during pregnancy or while breastfeeding.

Conclusions: After completion of the study, the findings would aid in producing harm reduction interventions by the healthcare physicians and advanced ¬¬practice providers (APP) to decrease cannabis use. This will be vital to help prenatal and six-month postpartum women who are using cannabis for health management to continuously evaluate their use. This study entertains the idea that understanding the perceptions of cannabis usage during pregnancy and six months postpartum will aid in professional healthcare communication between the physician and patient to best address the cannabis usage and its effects.