Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland, Baltimore, MD, United States.
Department of Obstetrics and Gynecology and Psychiatry, Virginia Commonwealth University, Richmond, VA, United States.
Prev Med. 2017 Nov;104:46-49. doi: 10.1016/j.ypmed.2017.05.012. Epub 2017 May 18.
Cannabis use is common and increasing among women in the United States. State policies are changing with a movement towards decriminalization and legalization. We explore the implications of cannabis liberalization for maternal and child health. Most women who use cannabis quit or cut back during pregnancy. Although women are concerned about the possible health effects of cannabis, providers do a poor job of counseling. There is a theoretical potential for cannabis to interfere with neurodevelopment, however human data have not identified any long-term or long lasting meaningful differences between children exposed in utero to cannabis and those not. Scientifically accurate dissemination of cannabis outcomes data is necessary. Risks should be neither overstated nor minimized, and the legal status of a substance should not be equated with safety. Decreasing or stopping use of all recreational drugs should be encouraged during pregnancy. Providers must recognize that even in environments where cannabis is legal, pregnant women may end up involved with Child Protective Services. In states where substance use is considered child abuse this may be especially catastrophic. Above all, care for pregnant women who use cannabis should be non-punitive and grounded in respect for patient autonomy.
美国的女性中，大麻的使用非常普遍，而且呈上升趋势。随着大麻非刑罪化和合法化运动的发展，各州的政策也在发生变化。我们探讨了大麻合法化对母婴健康的影响。大多数使用大麻的女性在怀孕期间会停止或减少使用。尽管女性担心大麻可能对健康产生影响，但提供者在咨询方面做得很差。大麻理论上有可能干扰神经发育，但人类数据并未发现宫内暴露于大麻的儿童与未暴露于大麻的儿童之间存在任何长期或持久的有意义差异。有必要科学准确地传播大麻的结果数据。风险既不应被夸大也不应被低估，而且物质的合法地位不应等同于安全性。应该鼓励孕妇在怀孕期间减少或停止使用所有娱乐性药物。提供者必须认识到，即使在大麻合法的环境中，孕妇也可能最终涉及儿童保护服务。在将药物使用视为虐待儿童的州，这可能是特别灾难性的。最重要的是，对于使用大麻的孕妇的护理应该是非惩罚性的，并基于对患者自主权的尊重。
