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Hume C, Baglot SL, Javorcikova L, Lightfoot SHM, Scheufen J, Hill MN. Effects of prenatal THC vapor exposure on body weight, glucose metabolism, and feeding behaviors in chow and high-fat diet fed rats. Int J Obes (Lond) 2024; 48:981-992. [PMID: 38528095 DOI: 10.1038/s41366-024-01512-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND 4-20% of people report using cannabis during pregnancy, thereby it is essential to assess the associated risks. There is some evidence that prenatal cannabis exposure (PCE) may be associated with increased risk for developing of obesity and diabetes later in life, however this has not been well explored under controlled conditions. The aim of this study was to use a translational THC vapor model in rodents to characterize the effects of PCE on adiposity, glucose metabolism, and feeding patterns in adulthood, with focus on potential sex differences. METHODS Pregnant Sprague Dawley rats were exposed to vaporized THC (100 mg/ml) or control (polyethylene glycol vehicle) across the entire gestational period. Adult offspring from PCE (n = 24) or control (n = 24) litters were subjected to measures of adiposity, glucose metabolism and feeding behavior. Rats were then placed onto special diets (60% high-fat diet [HFD] or control 10% low fat diet [LFD]) for 4-months, then re-subjected to adiposity, glucose metabolism and feeding behavior measurements. RESULTS PCE did not influence maternal weight or food consumption but was associated with transient decreased pup weight. PCE did not initially influence bodyweight or adiposity, but PCE did significantly reduce the rate of bodyweight gain when on HFD/LFD, regardless of which diet. Further, PCE had complex effects on glucose metabolism and feeding behavior that were both sex and diet dependent. No effects of PCE were found on plasma leptin or insulin, or white adipose tissue mass. CONCLUSIONS PCE may not promote obesity development but may increase risk for diabetes and abnormal eating habits under certain biological and environmental conditions. Overall, this data enhances current understanding of the potential impacts of PCE.
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Affiliation(s)
- Catherine Hume
- Hotchkiss Brain Institute | Mathison Centre for Mental Health Research & Education | Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
- Department of Cell Biology & Anatomy | Department of Psychiatry, University of Calgary, Calgary, AB, Canada.
| | - Samantha L Baglot
- Hotchkiss Brain Institute | Mathison Centre for Mental Health Research & Education | Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Graduate Program in Neuroscience, University of Calgary, Calgary, AB, Canada
| | - Lucia Javorcikova
- Hotchkiss Brain Institute | Mathison Centre for Mental Health Research & Education | Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Graduate Program in Neuroscience, University of Calgary, Calgary, AB, Canada
| | - Savannah H M Lightfoot
- Hotchkiss Brain Institute | Mathison Centre for Mental Health Research & Education | Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Graduate Program in Neuroscience, University of Calgary, Calgary, AB, Canada
| | - Jessica Scheufen
- Hotchkiss Brain Institute | Mathison Centre for Mental Health Research & Education | Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Graduate Program in Neuroscience, University of Calgary, Calgary, AB, Canada
| | - Matthew N Hill
- Hotchkiss Brain Institute | Mathison Centre for Mental Health Research & Education | Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
- Department of Cell Biology & Anatomy | Department of Psychiatry, University of Calgary, Calgary, AB, Canada.
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Oliveira Silveira J, Caino Teixeira Marchiori MR, da Silveira A, Porto da Silva F, Tisott ZL, Marques Monçalves KL, Siepmann Soccol KL. Motivations and expectations of pregnant women using psychoactive substances during prenatal care: phenomenological study. INVESTIGACION Y EDUCACION EN ENFERMERIA 2024; 42:e10. [PMID: 39083837 PMCID: PMC11297464 DOI: 10.17533/udea.iee.v42n2e10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 05/20/2024] [Indexed: 08/02/2024]
Abstract
Objective Understand the motivations and expectations of pregnant women using psychoactive substances during prenatal care. Methods A qualitative study developed in the light of Alfred Schütz's Theoretical Framework of Phenomenological Sociology, in which 25 pregnant women using psychoactive substances, belonging to a Family Health Strategy, participated. Data production took place between August and November 2022. Results Two units of meanings emerged: (i) social influences for the performance of prenatal care and (ii) expectation regarding the care to be received by the health professional. Pregnant women do pre-natal due to family influences, for fear of losing their children due to loss of guardianship and concern about the well-being and development of the baby. And, the expectations are that they receive good attention, feel safe when they are attended to by health professionals and also that they are understood and have a relationship of trust. Conclusion Pregnant women who use psychoactive substances bring motivations for prenatal care linked to the past, such as influences from family members and previous experiences. As for expectations, they are related to the child's health and the care expected by professionals. Finally, strategies to reduce harm during pregnancy of users of psychoactive substances are fundamental for the effectiveness of care.
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Affiliation(s)
| | | | - Andressa da Silveira
- Nurse, PhD. Professor, Nurse College of the Federal University of Santa Maria. Palmeira das Missões, Brazil.
| | | | | | | | - Keity Laís Siepmann Soccol
- Nurse, PhD. Professor, Professional Master in Maternal and Child Health. Franciscana University. Santa Maria, Brazil.
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Ryan JE, McCabe SE, Wilens TE, Weigard A, Worster B, Veliz P. Prenatal Polysubstance Use and Attention-Deficit/Hyperactivity Disorder (ADHD). Am J Prev Med 2024; 66:548-550. [PMID: 38070629 PMCID: PMC10922843 DOI: 10.1016/j.amepre.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/30/2023] [Accepted: 11/30/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Jennie E Ryan
- Thomas Jefferson University, College of Nursing, Philadelphia, Pennsylvania.
| | - Sean Esteban McCabe
- University of Michigan, School of Nursing, Center for the Study of Drugs, Alcohol Smoking and Health, Ann Arbor, Michigan
| | - Timothy E Wilens
- Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Alexander Weigard
- Department of Psychiatry, University of Michigan, University of Michigan Addiction Center, Ann Arbor, Michigan
| | - Brooke Worster
- Thomas Jefferson University, Sidney Kimmel Medical College, Philadelphia, Pennsylvania
| | - Philip Veliz
- University of Michigan, School of Nursing, Center for the Study of Drugs, Alcohol Smoking and Health, Ann Arbor, Michigan
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Park Y, Dang EP, Board A, Gilboa SM, Ondersma SJ, Smid MC, Shakib JH, Mitchell KT, England LJ, Broussard CS, Meaney-Delman D, Iskander J, Kim SY. Polysubstance Use in Pregnancy: Surveillance, Interventions, and Next Steps. J Womens Health (Larchmt) 2023; 32:899-904. [PMID: 37552850 PMCID: PMC10558011 DOI: 10.1089/jwh.2023.0341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
Substance use during pregnancy increases risk for a wide range of adverse maternal and neonatal health outcomes. Polysubstance use is common among people who use substances during pregnancy; however, the risks of combined substance exposures during pregnancy are poorly understood. In this report, we provide an overview of the activities of the Centers for Disease Control and Prevention (CDC) and partners and identified gaps related to (1) surveillance, (2) routine screening, and (3) prevention of polysubstance use during pregnancy. Efforts by CDC and other partners to reduce polysubstance use during pregnancy can improve the health of pregnant people and their infants and children.
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Affiliation(s)
- Youngjoo Park
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee, USA
| | - Elizabeth P. Dang
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Amy Board
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Suzanne M. Gilboa
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Steven J. Ondersma
- Department of Public Health, Michigan State University, East Lansing, Michigan, USA
| | - Marcela C. Smid
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA
| | - Julie H. Shakib
- Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | | | - Lucinda J. England
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cheryl S. Broussard
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Dana Meaney-Delman
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John Iskander
- Office of Science, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shin Y. Kim
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Shen J, Hua G, Li C, Liu S, Liu L, Jiao J. Prevalence, incidence, deaths, and disability-adjusted life-years of drug use disorders for 204 countries and territories during the past 30 years. Asian J Psychiatr 2023; 86:103677. [PMID: 37348194 DOI: 10.1016/j.ajp.2023.103677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/03/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023]
Abstract
Drug use disorders are increasingly recognized as the main cause of public health issues worldwide. The current analysis aims to provide the most comprehensive, updated estimates of the burden from drug use disorders at global, regional, and national levels during the past three decades. Prevalence, incidence, deaths, and disability-adjusted life-years (DALYs) were estimated from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 by age and sex for drug use disorder as well as its four main categories (opioid use disorders, cocaine use disorders, amphetamine use disorders, and cannabis use disorders) in 204 countries and territories between 1990 and 2019. DisMod-MR 2.1, and Bayesian meta-regression were used to analyze prevalence and incidence, while the Cause of Death Ensemble model (CODEm) was used to estimate death of diseases. Globally, the burden of drug use disorders, as measured by the average annual percentage change (AAPC) of deaths and DALYs, continues to increase. The patterns by regions of DALYs due to drug use disorders varied significantly, and it is mainly in developed countries and concentrated among young people and males. Programs for drug use disorders management should be improved, particularly in opioid use disorders. Governments will face increasing demand for treatment and support services, and effective prevention as well as control strategies are required to reduce the burden from these causes.
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Affiliation(s)
- Jianbo Shen
- Department of Neurosurgery, Jincheng People's Hospital, Jincheng 048000 China
| | - Guangyao Hua
- Department of Cardiovascular Medicine, The Sixth Affiliated Hospital of Guangzhou MedicalUniversity, Qingyuan People's Hospital, Qingyuan 511518 China
| | - Cong Li
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080 China
| | - Shunming Liu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080 China
| | - Lei Liu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080 China.
| | - Jinghua Jiao
- Department of Anesthesiology, Affiliated Central Hospital of Shenyang Medical College, 110020, China; Department of Anesthesiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080 China.
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Barber CM, Terplan M. Principles of care for pregnant and parenting people with substance use disorder: the obstetrician gynecologist perspective. Front Pediatr 2023; 11:1045745. [PMID: 37292372 PMCID: PMC10246753 DOI: 10.3389/fped.2023.1045745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 04/17/2023] [Indexed: 06/10/2023] Open
Abstract
Substance use in pregnant and parenting persons is common, yet still underdiagnosed. Substance use disorder (SUD) is one of the most stigmatized and undertreated chronic medical conditions, and this is exacerbated in the perinatal period. Many providers are not sufficiently trained in screening or treatment for substance use, so gaps in care for this population persist. Punitive policies towards substance use in pregnancy have proliferated, lead to decreased prenatal care, do not improve birth outcomes, and disproportionately impact Black, Indigenous, and other families of color. We discuss the importance of understanding the unique barriers of pregnancy-capable persons and drug overdose as one of the leading causes of maternal death in the United States. We highlight the principles of care from the obstetrician-gynecologist perspective including care for the dyad, person-centered language, and current medical terminology. We then review treatment of the most common substances, discuss SUD during the birthing hospitalization, and highlight the high risk of mortality in the postpartum period.
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Affiliation(s)
- Cecily May Barber
- Grayken Center for Addiction, Boston Medical Center, Boston, MA, United States
- Department of Obstetrics and Gynecology, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States
| | - Mishka Terplan
- Friends Research Institute, Baltimore, MD, United States
- Department of Family and Community Medicine, University of California, San Francisco, CA, United States
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Stewart A, Ko J, Salvesen von Essen B, Levecke M, D’Angelo DV, Romero L, Cox S, Warner L, Barfield W. Association of Mental Health Conditions, Recent Stressful Life Events, and Adverse Childhood Experiences with Postpartum Substance Use - Seven States, 2019-2020. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2023; 72:416-420. [PMID: 37079476 PMCID: PMC10121265 DOI: 10.15585/mmwr.mm7216a1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Most pregnancy-related deaths due to mental health conditions, which include overdose and poisoning related to substance use disorder, occur during the late (43-365-day) postpartum period (1). Adverse childhood experiences and stressful life events are associated with increased substance use during pregnancy (2,3). Pregnancy Risk Assessment Monitoring System (PRAMS) respondents in seven states with high opioid overdose mortality rates were recontacted 9-10 months after giving birth in 2019 and asked about postpartum prescription opioid misuse,* tobacco use, unhealthy alcohol use,† and use of other substances.§ Substance and polysubstance use prevalence estimates were calculated, stratified by mental health and social adversity indicators. Overall, 25.6% of respondents reported postpartum substance use, and 5.9% reported polysubstance use. The following conditions were associated with higher substance and polysubstance use prevalence in postpartum women: depressive symptoms, depression, anxiety, adverse childhood experiences, and stressful life events. Substance use prevalence was higher among women who experienced six or more stressful life events during the year preceding the birth (67.1%) or four adverse childhood experiences related to household dysfunction (57.9%). One in five respondents who experienced six or more stressful life events in the year before giving birth and 26.3% of women with four adverse childhood experiences reported postpartum polysubstance use. Clinical and community- and systems-level interventions to improve postpartum health can include screening and treatment for depression, anxiety, and substance use disorders during the postpartum period. Evidence-based strategies can prevent adverse childhood experiences and mitigate the immediate and long-term harms.¶.
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