The fetal effects of marijuana use by pregnant
Women mirror fetal alcohol syndrome
ABSTRACT
In many situations, people who use marijuana regularly claim that it has none of the long-term side effects of alcohol and that its short-term use creates a very different “high” than alcohol use, leaving the user more open and relaxed and less confrontational. These addicts usually alsoclaim that there are no negative side effects of marijuana usage. This paper will examine several studies which establish the effects of marijuana usage by a pregnant woman on her unborn fetus. Among the most notable effects which will be explained and examined in depth is a tendancy among infants born to marijuana-smoking mothers to have similar traits to those born with fetal alcohol syndrome.
RESEACH QUESTION
Does the use of marijuana during pregnancy affect the development of the fetus? More specifically, what impact does the use of marijuana have on fetal development as compared to the fetal development in pregnant women who do not use marijuana.
HYPOTHESIS
Most heavy users of marijuana assert that there are no significant side effects to the use of the drug. This study will attempt to determine if that is true. Smokiing marijuana during pregnancy is as dangerous as consuming alcohol during pregnancy and leads to fetal development issues similar to fetal alcohol syndrome.
INTRODUCTION
Many published studies regarding the use of marijuana and its effects of pregnancy are several decades old and may not reflect current medical technology and may need closer controls to determine if the studies are an accurate reflection of the use of marijuana on fetal development. In 1982, for example, a study of nearly 1700 pregnant women lead to the conclusion that women with heavy marijuana usage were five times more likely to deliver a child with signs of fetal alcohol syndrome than women who did not use marijuana (Hingson 1982). That study accounted for several different variables which could affect fetal development and pronounced that marijuana use by the mother seemed to have a profound negative effect on everything ranging from birth weight to neurological development. A 2002 longitudinal study and retrospective of more than 500 children, demonstrated the link between mothers who use dugs during pregnancy, including marijuana and Attention Deficit Hyperactivity Disorder in children (Mick 2002). The main problem with this study is that it did not sufficiently isolate the variables which may have contributed to the findings, lumping alcohol and drug use together, rather than offering separate results based on the use fo a specific drug.
In a study published in 1989, researchers found that children born to mothers who used marijuana had a significantly different cry than those born to non-users (Lester 1989). This is considered to be a significant indicator of neurological problems in the infants and is similar to findings regarding children born to other addicts. In a 1983 study, researchers examined the medical records of nearly 13,000 women and their infacts to examine the potetntial correlation between marijuana use and infant development. The study appeared to indicate that children of marijuana-users had a lower birth birth weight, shorter gestation time and higher incidents of major malformations (Linn 1984). The researchers were not confident in their data regarding major malformations and called for additional study on the topic. This conclusion was echoed by a study published in 1998 indicating that primary care physicians and obstetricians must work harder to identify substance abuse in pregnant women because of its potential effects on the fetus (Ebrahim 1998).
METHOD
This study will consist of late pregnancy contact with a variety of women within the region and will assess them during pregnancy for signs of marijuana or other drug usage. To confirm drug usage, we will be using urine drug tests so that we are not relying solely on self-reporting as a measure of drug use. Mothers will be asked to self-report various behaviors during pregnancy and to allow us access to post-birth health examinations of the children. Attempts will be made to control for those who are multiple drug users and for non-related pregnancy risk factors including weight gain and nutrition in the mothers and family history of birth defects, low birth weights and short gestation periods.
PARTICIPANTS
A population sample of pregnant women will be needed for this study. To identify these women randomly, we will seek assistance from the local health agencies including the local Women Infant Child nutrition program and from local private health care providers seeking willing participants. In addition, we may advertise in local media for participants. Participation in the study will be completely voluntary and is somewhat more likely to attract drug users because of the population base it is likely to attract. By including WIC participants, it is hoped that we will negate some of the additional factors which could impact fetal development including parental nutrition.
APPARATUS
This study will use paired surveys, from during pregnancy and after the child’s birth to have the parent self-report any potentially risky behaviors, including drug use, that may affect the child’s development and a post-birth survey asking for parental observations regarding the child’s behaviors.
We will also be using medical records releases for all of the women involved so that we may track the birth records of the children involved and observations of the medical professionals assisting in the pregnancy regarding the mother’s drug usage.
Furthermore, we will be using urine drug testing supplies to confirm the self-reporting by our participants. It is anticipated that some participants may not self-report accurately due to fears over the impression that will result from their drug use or fear of reprisal.
PROCEDURES
Participants will be asked to complete a self-reporting questionnaire several times during the pregnancy and will be asked to complete a personal interview with research staff at the beginning of the study and after the birth of the child. Participants will be asked to complete urine drug tests three times over the course of the pregnancy and will be asked to release their medical records to researchers for purposes of observation and elimination of correllary factors. It is anticipated that the impact on participants will be no more than a few horus time over the course of approximately one year.
RESULTS/DISCUSSION
The effort of this study will be to verify all self-reported information with clinical data. Therefore, drug tests will be administered to participants and medical records will be used to v erify clinical findings regarding children’s health.
RESULTS
Statistical analysis of the hard data will be used to determine if there is any correlation between marijuana use and low birth weight and neurological development in the children boirn to marijuana usings mothers. The non-using mothers will be used as a control group for comparison, but we will also compare marijuana-users data to national averages to determine if any statistical differences exist.
With access to the medical records and use of the questionnaires we also hope to identify additional variable which might impact the study and use prior research to control for those variable in our final analysis. The conclusions of the study will be based on that final analysis.
DISCUSSION
It is our fear that this study will not be sufficiently large enough to determine the negative effects of marijuana usage on fetal development or that we will be unable to account for additional variables which may impact fetal development. The problem with tackling an issue of this magnitude is that the number of variables is great and it is possible that once we control for all the potential variables, the statistical significance of the data may be minimized. If the study does not bear out the results of previous studies, it could be due to the institution of clinical verification of participant claims or it could be that marijuana usage does not affect each person in the same way. In addition, there is no good way other than self-reporting to determine how heavy the marijuana usage is and this may also account for major difference in fetal development.
REFERENCES
Ebrahim, shahul H. MD, PhD and Joseph Gfroerer “Pregnancy-Related Substance Use in the United States During 1996–1998” Centers for Disease Control and Prevention, Atlanta, Georgia; and Substance Abuse and Mental Health Services Administration, Rockville, Maryland. <http://acogjnl.highwire.org/cgi/content/abstract/101/2/374> July 27, 2007.
Hingson, Ralph ScD, Joel J. Alpert MD, Nancy Day PhD, Elizabeth Dooling MD, Herbert Kayne PhD, Suzette Morelock EdM, Edgar Oppenheimer MD, and Barry Zuckerman MD. “Effects of Maternal Drinking and Marijuana Use on Fetal Growth and Development” <http://pediatrics.aappublications.org/cgi/content/abstract/70/4/539> July 27, 2007.
Lester, Barry M. and Melanie Dreher “Effects of Marijuana Use During Pregnancy on Newborn Cry” Child Development, Vol. 60, No. 4 (Aug., 1989), pp. 765-771.
Linn, S., S C Schoenbaum, R R Monson, R Rosner, P C Stubblefield, and K J Ryan. “The association of marijuana use with outcome of pregnancy” 2003. <http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1651077>, July 27, 2007.
MICK, ERIC SC.D.; BIEDERMAN, JOSEPH M.D.; FARAONE, STEPHEN V. PH.D.; SAYER, JULIE B.A.; KLEINMAN, SETH M.S.W. “Case-Control Study of Attention-Deficit Hyperactivity Disorder and Maternal Smoking, Alcohol Use, and Drug Use During Pregnancy. “ Journal of the American Academy of Child & Adolescent Psychiatry. 41(4):378-385, April 2002. <http://www.problemsinanes.com/pt/re/jaacap/abstract.00004583-200204000-00009.htm;jsessionid=GrVpHTKTW2nFJ2Q5G0GZ7hZQTtHM9450KzM2CChhn1XX1D1Q78bt!1267112738!181195629!8091!-1 > July 27, 2007.
