Possible Associations Between Recreational Cannabis and Birth Outcomes

The association between the legalization of recreational marijuana and both small for gestational age births and NICU admissions in Colorado

In Summary

Researchers have recently found no evidence that the legalization of recreational cannabis increases the risk for small gestational age (SGA) births but may be linked to neonatal intensive care unit (NICU) admissions immediately post-birth. The study merely looks at the prevalence of both SGA and NICU admissions immediately post-legalization of recreational cannabis in Colorado and claims no causation conclusions can be drawn from the gathered data but did note an increase of 1% of NICU admissions per month immediately following legalization. The rate of the SGA births decreased following the new laws meaning cannabis may not affect the growth of a fetus or could improve development but future research is encouraged to ensure these results and identify possible causation for an increase in NICU admissions, which could be due to a myriad of factors. 

This article serves as a call for research so that patients who take cannabis and fall pregnant are fully aware of the possible risks associated with continuing cannabis use during pregnancy. Currently, most obstetricians and gynecologists advise against cannabis use due to the lack of knowledge concerning cannabis and fetal development but those who fall pregnant and rely on cannabis are often left unaware of alternative options. Considering the uncertainty of the effects of cannabis on pregnancy outcomes and the inconsistency between the few studies currently published more research is definitely needed so that pregnant women can continue to receive safe and effective treatment. 

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Benjamin Caplan, MDPossible Associations Between Recreational Cannabis and Birth Outcomes
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Low Doses of Cannabis Improve Sperm Count

In Summary:

A recent study has found that “Men who had ever smoked marijuana had higher sperm concentration and count and lower serum FSH concentra- tions than men who had never smoked marijuana; no differences were observed between current and past marijuana smokers.” Cannabinoid receptors are found in several components of the male sexual reproductive system, including the testes, vas deferens, and human sperm cells, and the activation of the receptors seems to be dose-dependent (greater action follows greater dosages.) Participants who had consumed lower doses had higher sperm count and concentration but participants who had consumed high doses had lower sperm count and concentration. Further research is needed to confirm causation.

There is a body of research supported by the National Institute for Drug Abuse, in humans and animal models, that has shown that so-called “abusive exposure” to marijuana smoking may adversely impact spermatogenesis. Data is less clear for moderate consumption levels and multiple studies have found higher serum testosterone concentrations among marijuana consumers.

Some important notes in the article:

The results may not be generalizable to all men. They used self-report as a tool of assessing cannabis exposure, which comes with fair reason to question the precision of the data collected. They also note that “these findings are not consistent with a deleterious effect of marijuana on testicular function. Whether these findings are reflective of the previously described role of the endocannabinoid system in spermatogenesis or a spurious association requires confirmation in further studies.”

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Benjamin Caplan, MDLow Doses of Cannabis Improve Sperm Count
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Dr Caplan’s response to Surgeon General advisory statement

Last week’s statement by the US Surgeon General


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Benin Republic Hemp Improves Male Fertility

Cannabinoid-deficient Benin republic hemp (Cannabis sativa L.) improves semen parameters by reducing prolactin and enhancing antioxidant status

Cannabis sativa, specifically Nigerian hemp, has been found to have adverse effects on male fertility. It’s use has been linked to a decrease in semen parameters, germ cell proliferation, and reproductive organ weight. It can induce hyperprolactinemia, a condition causing infertility in 11% of men with low sperm count.

Data from the National Drug Law Enforcement Agency in Nigeria has suggested users preferentially obtaining hemp from the Benin Republic. In a recent study investigating the composition of Benin republic hemp, a lack of THC and lower levels of cannabinol were observed. Additionally, an ethanol extract of Benin republic hemp increased sperm count, morphology, and viability.   

Additional Point: Certain phytocannabinoids found in cannabis have demonstrated a detrimental effect on male fertility. However, analysis of hemp from the Benin republic shows a low to no levels of these toxic cannabinoids and evidence points to this particular hemp enhancing male fertility.

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Benjamin Caplan, MDBenin Republic Hemp Improves Male Fertility
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