Wednesday, December 21, 2011

Smoking Marijuana While Pregnant- Why The Jamacian Study Doesn't Matter

Photo from this site
Once upon a time I did a post on why women shouldn't smoke marijuana while pregnant.  You should read it.

I am staunchly opposed to the recreational use of drugs (and yes I consider marijuana a drug) while pregnant.  In fact, I tend to agree with Dr Bradley, that there is no drug proven to be safe for the unborn baby.  

If you don't need a drug and the benefit doesn't outweigh the risk, then I am of the mind that those things should be avoided....just in case.  Babies, and their health, is nothing to be trifled with.   

Oddly though, the same women who are staunchly opposed to drugs in labor, find the use of the "natural plant" to be just fine while pregnant.  

Discussion concerning marijuana smoking while pregnant is heated and emotional (especially I noticed, by people named anonymous).  But one thing that is brought up often to SUPPORT the use of marijuana while pregnant is something referred to as "The Jamaican Study."

The Jamaican study, which you can read here, is said to prove that not only do babies whose mothers smoke marijuana while pregnant do just fine, they are actually SUPERIOR to non-exposed infants. 

I want to take a few minutes to point out some of the reasons why the "Jamaican study" is not a sufficient reason to embrace recreational use of marijuana while pregnant. 
 ~
One of the first problems with this study is the size of the sample used- only 24 babies were exposed to marijuana prenatally and only 20 were in the unexposed group.  A grand total of 44 babies.   

This is a TINY sample size.  Personally, even when I find studies that I WANT to agree with, I dismiss them when the sample size is that small.  

Is this really a big enough group to make broad statements about what is safe or not in pregnancy?  

Babies in the study were scored using something called the Brazelton Neonatal Behavioral Assessment Scale at one day of life and again at one month.  The researchers admit that findings have been conflicting from other researchers on this same subject.  This is NOT a study that has been replicated over and over again, quite the contrary.  The ability to reproduce results is something often used to "prove" the validity of a study.  In this case, it has not been done.
" Despite the prevalence of marijuana use among women of childbearing age, reports on the behavioral teratogenic effects of prenatal marijuana exposure have been conflicting and inconclusive. Fried and Makin, for example, found that moderate levels of marijuana use in their middle-class Ottawa sample (7.0 joints per week) were associated with poorer habituation to light, higher levels of irritability, and increased tremors and startles as assessed by the Brazelton Neonatal Behavioral Assessment Scale (NBAS) between the third and sixth days of life."
Another problem with the Jamaican study is that the results really cannot be applied to women in America. Why? Because:


"The sample was drawn from the vast category of "rural poor," which constitute the majority of the population of this region of Jamaica. "
They were looking at a group of women who matched each other closely in income level- but they and their lifestyle, do NOT translate well to the average American woman.  These are women who differ in many ways - income, access to nutrition, lifestyle culture, etc, from women in America.  The results of this study can't necessarily be considered important to a very different population here or in other wealthier nations. 

One thing that is often problematic in studies looking at marijuana use in pregnancy is separating out the use of this substance from the use of other substances.  What is really causing changes in test results?  Is it marijuana or is it another substance?  I had assumed that this study in particular was often cited by those supporting marijuana use in pregnancy because it did this. 
 "The use of alcohol and tobacco was minimal in both groups and did not exceed 3 beers or 15 tobacco cigarettes per week for any of the women in the study"
Alcohol and cigarette use in the study wasn't excessive- but it WAS NOT completely eliminated either.  Those are both known to impact fetal development.  

Another reason why the results of this study are flawed is that the heaviest users of marijuana actually had the highest education level.  Could it be that the education of the mother has an impact on the babies ability to test well? 
"First, as a group, the heavy users had the highest level of education. All the heavy users had had some schooling beyond the primary school level and three had had some post secondary training."
 Not only did the heaviest users have higher education levels, they also had more control over resources in their home.  This suggests that possibly they were able to have more control over what they ate- and some believe that maternal diet can impact the health of the baby.  
" The heavy-marijuana-users did not have more income and status than the other women, but they did have more control over how they acquired and spent their resources."
 Now- to the results.  
 "The heavily exposed neonates were more socially responsive and were more autonomically stable at 30 days than their matched counterparts. The quality of their alertness was higher; their motor and autonomic systems were more robust; they were less irritable; they were less likely to demonstrate any imbalance of tone; they needed less examiner facilitation to become organized; they had better self-regulation; and were judged to be more rewarding for caregivers than the neonates of nonusing mothers at 1 month of age."
 At one month the children of heavy using mothers did better on the given test.  This much is true.  Why doesn't it matter?  Why isn't this enough evidence to say "Go smoke a joint for a smarter baby!!!!"  The quote below illustrates this well:
  
" Furthermore, unlike the United States, in which heavy marijuana use often is associated with maternal incompetence and a suboptimal caregiving environment, the data from this study indicate that in Jamaica, the heavy-marijuana-using mother's education, independence, and greater access to resources converge in a constellation of maternal competence and a supportive context for neonatal development."
 Aaaaahhhhhhh..............

This is big.  If you read the study in full, you will find that the heavy marijuana users had the most social support.  They had fewer little children at home, they had more adults to help them and so - yes - their babies did seem to respond better in the tests.  But even the researchers thought that this improved testing could have a lot to do with the different situations the heavy using mothers were in, as opposed to the nonusers and NOT necessary the use of marijuana.  

So- a quick recap on all the things that make the "Jamaican study" a joke.  

1.  The sample size was laughably small.

2.  The study has not been replicated.

3.  The study did not eliminate other substances known to impact fetal development such as alcohol or tobacco.

4.  The mothers who used the most marijuana while pregnant had the highest education level.

5.  The mothers with the most usage also had a more supportive home environment than the non-using mothers.

6.  The researchers themselves noted that this could have had an impact on their study results.  
But- if that is not enough to convince you that marijuana is not a good thing for your baby- how about this-  this study ONLY looked at the babies at one month of age.  What happens to them LATER in life?  Does marijuana use in the mother impact later development?  

It is known that many drugs can impact the baby but not SHOW until much later in life.  

These studies both showed that marijuana smoking was correlated with a negative impact on children when they were the age of ten. 



And here is another showing that cannabis impacts the baby negatively.


End results- the Jamaican study doesn't prove that smoking marijuana while pregnant is good for you baby.  If anything it shows that the environment surrounding a baby being supportive can be helpful in that infants development.  It doesn't show these babies are better off when they are adults or older children.  It doesn't really show much of anything about marijuana being good for the newborn.  

I wish that women would carefully consider the impact of what they smoke on their children.  We can't assume that something is "good" for our babies because our friends babies seem fine or because one study shows that it is a good thing.  

It is time we stopped making excuses for ourselves just because we don't want to give up part of our old lifestyle when we are pregnant.  Choose your baby first. 

No comments:

Post a Comment