What are the risks of using CBD (cannabidiol) gummies versus THC (tetrahydrocannabinol) products during pregnancy?

Risks of CBD Gummies vs THC Products During Pregnancy

Both CBD and THC products should be completely avoided during pregnancy as they may negatively affect fetal brain development and increase the risk for premature birth. 1

Comparative Risks of CBD vs THC in Pregnancy

Both CBD and THC Products:

• The U.S. Surgeon General and FDA explicitly advise pregnant and breastfeeding individuals to avoid using cannabis in any form, including CBD products 1
• Both can potentially harm fetal development, though through different mechanisms

THC-Specific Risks:

• Associated with negative effects on fetal brain development 1
• Linked to increased risk of premature birth 1
• Associated with neuropsychiatric adverse outcomes in offspring, including:
  • Autism Spectrum Disorder (ASD)
  • Attention-Deficit/Hyperactivity Disorder (ADHD)
  • Psychosis proneness
  • Internalizing and externalizing problems
  • Impaired executive function 2
• Maternal health risks include:
  • Increased risk of gestational hypertension (17% higher)
  • Preeclampsia (8% higher)
  • Abnormal gestational weight gain
  • Placental abruption (19% higher) 3

CBD-Specific Risks:

• Despite common misconception that CBD is "safer," the FDA specifically warns against CBD use during pregnancy 1
• CBD products often contain unregulated amounts of THC
• Quality control in CBD products is frequently inadequate, with inaccurate labeling 1
• CBD can cause liver enzyme elevation and potential drug-induced liver injury 1

Why Pregnant Women Use Cannabis Despite Warnings

Many pregnant women continue cannabis use after pregnancy recognition:

• 61.9% of users in one study continued use after learning they were pregnant 4
• Those who considered their use "medical" were 4 times more likely to continue 4
• Common reasons include managing health problems, particularly among those with adverse childhood experiences 5
• Symptom control is frequently cited as the reason for continued use 4

Clinical Recommendations

1. Screening and Education:

   • Healthcare providers should routinely ask all pregnant patients about cannabis use, including CBD products 6
   • Provide clear education about risks to both mother and fetus

2. For Patients Using Cannabis for Symptom Management:

   • Identify the specific symptoms being treated (commonly nausea, anxiety, pain)
   • Offer evidence-based alternatives for symptom management
   • Emphasize that both CBD and THC products pose risks to fetal development

3. For Patients with Substance Use Disorder:

   • Recognize that 10% of chronic cannabis users may develop cannabis use disorder 1
   • Withdrawal symptoms can include irritability, restlessness, anxiety, sleep disturbances, and abdominal pain 1
   • Refer to appropriate substance use treatment services

Important Caveats

• Many commercially available CBD products contain varying amounts of THC, often inaccurately labeled 1
• The potency of cannabis products has increased dramatically in recent years, with average THC concentration almost doubling from 9% in 2008 to 17% in 2017 1
• Current research may underestimate risks as most studies were based on cannabis exposures that occurred decades ago when products were less potent 2
• Healthcare providers often feel uninformed about cannabis risks during pregnancy, with only 51.4% routinely asking patients about drug use 6

The evidence clearly indicates that no form of cannabis, whether CBD or THC, should be considered safe during pregnancy, and complete abstinence is the only recommendation supported by current medical evidence.