CBD Oil in Pregnancy

CBD Oil seems to be the hot new product that cures all sorts of ailments: anxiety, depression, nausea, seizures, inflammation, and insomnia just to name just a few.  CBD oil is available in sorts of different products: gums, candies, lotions, hair products, capsules, vape oil.   At prenatal visits, I get asked all the time- Is it safe to use CBD oil products for my nausea while I’m pregnant?

1. So, let’s start with what is CBD oil?  CBD oil is made by extracting cannabidiol from the flowers and buds from Marijuana or hemp plants and then diluting it with a neutral edible oil.  It does not have an intoxicating effect because it does not contain THC which is what causes the “high” when you smoke marijuana. 
2. Is there any medicinal use for Cannabidiol?  The FDA has only approved the medication Epidiolex to treat a rare form of childhood epilepsy.   Of the research done with cannabidiol, this is the only indication where the evidence suggests there may be some efficacy for treatment with cannabidiol.  For all its other purported benefits, there is not enough evidence for the FDA to recommend it as a treatment modality.  Also, whenever any product seems to be the panacea for so many different symptoms, there is always a concern about it being the new snake oil. 
3. Is CBD oil safe to use during pregnancy?  So unfortunately like most things, there are not enough studies for us to be able to say with certainty that CBD oil is safe in pregnancy.  However, several studies have found that there is an increased risk of preterm birth, small for gestational age babies, placental abruption, and increased admission to the Neonatal Intensive care unit for moms who used marijuana while pregnant.  Long term neurologic studies in children whose mothers used marijuana while pregnant do show increased risk of attention and behavioral problems, impaired visual acuity, verbal reasoning and comprehension and short-term memory issues.  For these reasons the American Academy of Pediatrics, the American College of Obstetrics and Gynecology and the US Surgeon General all warn pregnant women not to smoke marijuana or use any of its byproducts.

So, at this point, the FDA hasn’t found CBD oil to be an effective treatment for pregnancy-related nausea, and the medical community is concerned about the safety of cannabinoid-based products as they may be related to negative pregnancy outcomes.  Also, while we are aware that the THC in marijuana is responsible for the “high,” there haven’t been any studies to determine which part of cannabis plants is dangerous in pregnancy.  Given the lack of proven efficacy and also the potential danger of these products, the safest course of action would be to avoid them in pregnancy until the FDA and the medical community suggest doing otherwise.

​Dr. Pam