Effects of delta9-tetrahydrocannabinol on hamster fetuses

Marijuana Use in Pregnancy: A Review

Importance

Marijuana is the most commonly used dependent substance in pregnancy. The main active chemical of marijuana (delta-9-tetrahydrocannabinol [THC]) readily crosses the placenta, and cannabinoid receptors have been identified in fetal brain and placenta. As a result, prenatal marijuana use could potentially have detrimental impact on fetal development.

Objective

This review aims to summarize the existing literature and current recommendations for marijuana use while pregnant or lactating.

Evidence Acquisition

A PubMed literature search using the following terms was performed to gather relevant data: "cannabis," "cannabinoids," "marijuana," "fetal outcomes," "perinatal outcomes," "pregnancy," "lactation."

Results

Available studies on marijuana exposure in pregnancy were reviewed and support some degree of developmental disruption, including an increased risk of fetal growth restriction and adverse neurodevelopmental consequences. However, much of the existing prenatal marijuana research was performed in the 1980s, when quantities of THC were lower and the frequency of use was less. Additionally, most human studies are also limited and conflicting as most studies have been observational or retrospective, relying primarily on patient self-report and confounded by polysubstance abuse and small sample sizes, precluding determination of a causal effect specific for marijuana. Given the paucity of evidence, it is currently recommended to avoid using marijuana while pregnant or when breastfeeding.

Conclusion and Relevance

There is a critical need for research on effects in pregnancy using present-day THC doses. Once the adverse perinatal effects of marijuana exposure are identified and well characterized, patient education and antenatal surveillance can be developed to predict and mitigate its impact on maternal and fetal health.

Marijuana, Spice 'herbal high', and early neural development: implications for rescheduling and legalization

Marijuana is the most widely used illicit drug by pregnant women in the world. In utero exposure to Δ⁹-tetrahydrocannabinol (Δ⁹-THC), a major psychoactive component of marijuana, is associated with an increased risk for anencephaly and neurobehavioural deficiencies in the offspring, including attention deficit hyperactivity disorder (ADHD), learning disabilities, and memory impairment. Recent studies demonstrate that the developing central nervous system (CNS) is susceptible to the effects of Δ⁹-THC and other cannabimimetics, including the psychoactive ingredients of the branded product 'Spice' branded products. These exocannabinoids interfere with the function of an endocannabinoid (eCB) system, present in the developing CNS from E12.5 (week 5 of gestation in humans), and required for proliferation, migration, and differentiation of neurons. Until recently, it was not known whether the eCB system is also present in the developing CNS during the initial stages of its ontogeny, i.e. from E7.0 onwards (week 2 of gestation in humans), and if so, whether this system is also susceptible to the action of exocannabinoids. Here, we review current data, in which the presence of an eCB system during the initial stage of development of the CNS is demonstrated. Furthermore, we focus on recent advances on the effect of canabimimetics on early gestation. The relevance of these findings and potential adverse developmental consequences of in utero exposure to 'high potency' marijuana, Spice branded products and/or cannabinoid research chemicals during this period is discussed. Finally, we address the implication of these findings in terms of the potential dangers of synthetic cannabinoid use during pregnancy, and the ongoing debate over legalization of marijuana.

A cannabinoid analogue of Delta9-tetrahydrocannabinol disrupts neural development in chick

Marijuana is the most commonly abused illicit drug by pregnant women. Its major psychoactive constituent, Delta(9)-THC (Delta(9)-tetrahydrocannabinol), crosses the placenta and accumulates in the foetus, potentially harming its development. In humans, marijuana use in early pregnancy is associated with miscarriage, a fetal alcohol-like syndrome, as well as learning disabilities, memory impairment, and ADHD in the offspring. Classical studies in the 1970 s have reached disparate conclusions as to the teratogenic effects of cannabinoids in animal models. Further, there is very little known about the immediate effects of Delta(9)-THC on early embryogenesis. We have used the chick embryo as a model in order to characterize the effects of a water-soluble Delta(9)-THC analogue, O-2545, on early development. Embryos were exposed to the drug (0.035 to 0.35 mg/ml) at gastrulation and assessed for morphological defects at stages equivalent to 9-14 somites. We report that O-2545 impairs the formation of brain, heart, somite, and spinal cord primordia. Shorter incubation times following exposure to the drug show that O-2545 interferes with the initial steps of head process and neural plate formation. Our results indicate that the administration of the cannabinoid O-2545 during early embryogenesis results in embryotoxic effects and serves to illuminate the risks of marijuana exposure during the second week of pregnancy, a time point at which most women are unaware of their pregnancies.

[Alcohol, tobacco and cannabis: Review of teratogenicity studies in animals]

Despite an intensive national campaign of information, the drugs most frequently consumed by young adults undoubtedly continue to be alcohol, tobacco and cannabis. If the impact of these drugs on the health of the consumers can be evaluated in conjunction with the clinical and epidemiologic data, the consequences on the embryo due to their consumption by the pregnant women can be appreciated thanks to the abundant literature describing their effects in the gravid animal. Taking into account the abundant literature available in multiple animal species, the zero drug recommendation should be widely diffused to pregnant women.

Mutagenicity, developmental toxicity and carcinogenicity of cannabis

Data on the mutagenicity, developmental toxicity and carcinogenicity of cannabis are reviewed in this article. The available evidence on the possible mutagenic effects of cannabinoids is still inconclusive. There is no consensus on the induction of point mutations, while some experimental results suggest that cannabinoids may cause chromosomal damage. Concerning the developmental effects of cannabis, an increased embryolethality and somatic growth retardation have been observed in animals, as well as changes in motor behaviour, after perinatal exposure to cannabinoids. An elevated risk for infertility has been suggested for women smoking marijuana. On the other hand, intrauterine exposure to cannabinoids may be followed by changes of behaviour later in childhood. Finally, the experimental work concerning the possible carcinogenic action of cannabinoids has shown that cannabis acts as a tumour promotor in animals. Epidemiological studies have incriminated cannabis smoking for the development of head and neck carcinomas and for carcinomas of the respiratory tract in humans, but several confounding factors have rendered this evidence inconclusive. At least part of the great popularity of cannabis smoking is due to the widespread belief that it is harmless. However, the studies presented in this review show that, despite their low acute toxicity profile, cannabinoids represent several risks in terms of chronic toxicity.

Effects of marihuana on pregnant rats and their offspring

Pregnant rats were intubated with marihuana extract (10, 150 mg/kg) from gestation day 3 to parturition. Control animals were pair-fed. At parturition pups were culled and assigned to nondrug-treated dams. A positive control group consisting of animals prenatally exposed to alcohol (6 g/kg/day) was included for comparison of birth weight data. Marihuana reduced food and water consumption and maternal weight gain. Pup weight at birth was reduced by about 10% relative to pair-fed controls in animals exposed to the high doses of marihuana, and by approximately 15% in pups exposed to alcohol relative to their pair-fed controls. Litter size and pup mortality at birth were not affected significantly. Postnatal mortality was increased and neonatal weight was decreased at 21 days in marihuana-treated offspring. At 11 weeks of age body weights of drug-treated females but not males, were still significantly less than that of pair-fed controls.