With growing public endorsement of the potential benefits of marijuana, it is important for health care providers to effectively counsel patients regarding its effects on fertility and future offspring.
In the United States, marijuana is the most used illicit drug among females of reproductive age and during pregnancy.1,2 The high prevalence is in part due to the legalization of marijuana, resulting in its availability and perceived safety.
Existing research suggests that marijuana use can adversely affect female reproductive health and that because its main active ingredient, Δ−9-tetrahydrocannabinol (THC), can cross the placenta and is found in breast milk, there is also concern about harm to the developing fetus and offspring.
Public health initiatives have advised those who are attempting to conceive or who are pregnant and lactating to abstain from using marijuana, but because the available safety data and literature are limited, most patients continue to use it. With growing public endorsement of the potential benefits of marijuana, it is important for health care providers to effectively counsel patients regarding its effects on fertility and future offspring.
Marijuana use can affect fertility and reproductive health by affecting ovulation and menstrual regularity.
There is sufficient evidence for the surgeon general,3 American College of Obstetricians and Gynecologists (ACOG),4 and the American Academy of Pediatrics (AAP)5 to recommend that females who are trying to conceive, who are pregnant, or who are lactating abstain from the use of THC.
According to the CDC, approximately 1 in 20 females self-reports the use of marijuana during pregnancy, but this is likely an underestimate.6
Prenatal marijuana use is associated with an increased risk of fetal growth restriction, low birth weight, preterm birth, and neonatal intensive care unit admissions.
Exposure to marijuana during pregnancy and through breastfeeding can be associated with impaired offspring cognitive development.