Pregnant women should completely avoid alcohol and cannabis, according to guidance from the Centers for Disease Control and the American College of Obstetricians and Gynecologists. Clear evidence on alcohol’s risks and emerging research on THC support comprehensive abstinence during pregnancy and lactation.
Alcohol Use During Pregnancy
No amount, timing, or type of alcohol is safe in pregnancy. Alcohol quickly crosses the placenta but the fetus has limited capacity to metabolize it, resulting in prolonged exposure during critical periods of growth and brain development. The fetal brain is particularly vulnerable.
Despite these warnings, CDC analyses show that 13% to 14% of pregnant women have current alcohol use, and about 5% reported binge drinking. Among those engaged in current drinking, 17.8% didn’t have a current health care provider. The figures represent hundreds of thousands of pregnancies annually with alcohol exposure.
Alcohol causes fetal alcohol spectrum disorders, a spectrum of lifelong conditions including growth restriction, characteristic craniofacial features, structural anomalies, and most consistently neurodevelopmental impairment affecting cognition, behavior, and adaptive functioning. FASD is entirely preventable by avoidance of alcohol during pregnancy.
Cannabis and THC Risks
Cannabis use during pregnancy is increasing. CDC data from eight states show that in 2017, 4.2% self-reported marijuana use during pregnancy; more recent estimates covering 2021 to 2023 indicate a 6.8% prevalence, with higher use in the first trimester.
Prenatal cannabis use is associated with low birth weight, small for gestational age size, preterm birth, admission to a neonatal intensive care unit, and sometimes perinatal mortality. A large study identified associations between prenatal cannabis use and gestational hypertension, preeclampsia, and placental abruption.
Additional concerns include effects on fetal neurodevelopment. Maternal cannabis use is associated with lower cortisol in children and a reduction in the high-frequency component of heart rate variability, which reflects increased stress sensitivity. The analysis also predicted higher anxiety in children of mothers who use cannabis.
Yasmin Hurd, Ph.D., director of the Addiction Institute at Mount Sinai Medical Center, states: “Pregnant women are being bombarded with misinformation that cannabis is of no risk. The reality is that cannabis is more potent today than even a few years ago. Our findings indicate that using it during pregnancy can have a long-term impact on children.”
Substance Combinations and Breastfeeding
Cannabis use during pregnancy frequently co-occurs with nicotine and alcohol use. Combined drug exposures amplify risks, with studies reporting higher rates of maternal morbidity, neonatal morbidity, and infant death among those exposed to cannabis and nicotine compared with exposure to either alone.
During breastfeeding, THC and other cannabinoids are measurable in human milk, with concentrations remaining elevated with repeated use over a single day. Infants in their first months of life have lower metabolism and kidney-clearance rates than adults, preventing them from detoxifying and excreting chemicals, leading to higher levels of toxic substances.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://us.headtopics.com/news/clear-data-on-alcohol-and-emerging-data-on-thc-support-78188556