Date of Award

Spring 4-20-2023

Document Type

Honors Thesis

Department/Major

Nursing

First Advisor

Robyn Rentschler, RN, MSN

Second Advisor

Dr. Jessica Warren, EdD, RN

Third Advisor

Katie Fransen, MSN, RN, CNEn

Keywords

marijuana use, cannabis use, pregnancy, prenatal

Abstract

Background

Marijuana is the most commonly used federally illicit substance in the United States, with the Centers for Disease Control and Prevention (CDC, 2022) reporting it was used by an estimated 48.2 million people in 2019. The legalization of marijuana for medical and recreational use, as well as its decriminalization over the past 20 years, has created a new challenge for healthcare providers and researchers. As of December 2022, 18 states and the District of Columbia have legalized recreational use, while the remaining 32 do not offer legalized recreational use (U.S. Department of Health and Human Services, 2022). Regardless of its legal status, people use marijuana, pregnant or not. A 2019 study using National Survey on Drug Use and Health data found just under a half a million participants, 4.71% used marijuana for medical and/or non-medical purposes while pregnant (Volkow, et al.).

Objectives

The objective of this rapid review is to determine if high quality research projects have identified the effect(s) of marijuana use during pregnancy on the pregnant person, the fetus, and what provider recommendations around the use of marijuana during pregnancy entail. The target population is pregnant patients. The intervention was marijuana use during pregnancy - medical or recreational use. The comparison was no marijuana use during pregnancy. The outcome examined was effects on the pregnant person and the fetus. This review set out to find published studies that answer this question: What are the most current provider recommendations on marijuana use during pregnancy, taking into account the effects of use on the pregnant person and the fetus?

Data Sources

PubMed (December 2017 to December 2022) and CINAHL Complete (via EBSCOhost) (December 2017 to December 2022).

Study Eligibility Criteria, Participants, and Interventions

Published articles related to marijuana use during pregnancy were included in this review. In order to be included, the articles were required to be peer reviewed, published in the last 5 years (2017-2022), in the English language, and accessible to students for free through the USD Library resources as a full text. Empirical studies as well as review studies were included.

Study Appraisal and Synthesis Methods

Evidence was synthesized by being placed into one or more of the following categories: (1) marijuana use causes negative effects in the fetus, (2) marijuana use does not cause negative effects in the fetus, (3) marijuana use causes negative effects in the pregnant person, (4) marijuana use does not causes negative effects in the pregnant person, (5) marijuana use has unknown effects on the pregnant person, (6) future research is needed, (7) provider/researcher recommendation given/suggested, and (8) other. The majority of studies included in this review were placed in two or more categories as their focus and results indicated several of the above listed categories.

Results and Limitations

This review found 499 articles, which was reduced to 39 after screening and relevance checks (see Table 1, Table 2, and Diagram 1 for a detailed analysis).

Conclusion and Implications of Key Findings

Several studies found negative outcomes to the fetus when the pregnant person used marijuana, while others found no negative outcomes. Some studies noted changes to the placenta when the participants used marijuana, while others noted no changes. Very few studies looked at the outcomes for the pregnant person. More research is needed to determine the full range of effects of marijuana use during pregnancy. In many studies, the time of use and amount were unable to be determined or directly correlated to the outcomes experienced by the fetus and the pregnant person. Looking at provider recommendations, the studies that included this topic stated providers should 1) encourage abstinence and 2) create an environment that allows for open communication between provider and patient, rather than one of fear and judgment.

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