Bioanalytical and methodological challenges in the evaluation of fetal Cannabis exposure

Cannabis Use in Pregnancy and Downstream effects on maternal and infant health (CUPiD): a protocol for a birth cohort pilot study

INTRODUCTION

Cannabis use in pregnancy and post partum is increasing. Accessibility to cannabis has expanded due to the legalisation of cannabis in Canada. Therefore, there is a critical need to monitor the impact of cannabis on pregnancy outcomes and infant neurodevelopment. This pilot study will assess the feasibility of modern recruitment and data collection strategies adapted to the current cannabis environment and inform the design of a multicentre prospective birth cohort.

METHODS AND ANALYSIS

We will establish a pregnancy and birth cohort of 50 cannabis users and 50 non-users recruited before delivery. We will follow the participants at regular visits from recruitment to 12 weeks post partum. Participants will provide demographic and socioeconomic data, report their cannabis use patterns, and provide biological samples. Biological samples include maternal and infant urine and blood, breastmilk/chestmilk, cord blood, cord tissue, placenta and meconium. All samples will be processed and stored at -80°C until analysis by immunoassay or liquid chromatography-tandem mass spectrometry to determine the presence of cannabis metabolites. In addition, partners will be invited to provide additional socioeconomic and substance use data.

ETHICS AND DISSEMINATION

Ethics was obtained from Ottawa Health Science Network Research Ethics Board through Clinical Trials Ontario (3791). Our findings will be published in peer-reviewed journals, presented at scientific conferences and shared broadly with patients, healthcare decision-makers, and project partners online and through social media.

TRIAL REGISTRATION NUMBER

NCT05309226.Cite Now.

The Effects of Cannabis on Female Reproductive Health Across the Life Course

Introduction: Cannabis is commonly used for its medicinal and therapeutic benefits and is also widely used as a recreational drug. Cannabis use has been increasing in Canada, including among Canadian women of reproductive age. Post-legalization, further increases in cannabis use are expected due to increased availability and lowered perceptions of harm. Although cannabinoids are well known for their effects on the central and peripheral nervous systems, endocannabinoid receptors have also been characterized throughout the female reproductive tract. Cannabinoids may affect many aspects of female reproductive health, including fertility, pregnancy outcomes with neonatal implications, and menopause. Purpose: To provide a comprehensive review of trends in cannabis use among women and review the impact of cannabis across the female reproductive lifespan. Methods: We searched PubMed and Cochrane Library databases using keywords and MeSH terms. Included studies reported the potential impact of cannabinoids on female fertility, pregnancy, transmission to breast milk, neonatal outcomes, and menopause. Results: The existing literature is primarily concentrated on the effect of cannabis use in pregnancy and breastfeeding, with little exploration of its impact on fertility and in later life. Studies are limited in number, with small sample sizes, and are hampered by methodological challenges related to confounding and other potential biases. Conclusions: There remain critical gaps in the literature about the potential risks of cannabis use, particularly in vulnerable populations, including pregnant women, women who are breastfeeding, and their infants. Given the rise in the prevalence of cannabis use, new, robust investigations into the consequences of cannabis exposure on female reproductive health are needed.