Marijuana, Drugs, and Pregnancy Complications -- Could Other Factors Be the Culprit?

Use of marijuana and other illicit drugs by women who are pregnant is a cause of great controversy and some political grandstanding. In a few cases, this has led to draconian actions, including felony prosecutions of women in Texas.

Such actions are justified by studies that show that use of drugs such as marijuana or cocaine while pregnant may lead to low birth weight and other adverse effects. But most of these studies have not controlled for all the other factors potentially affecting these women, including stress, lack of early prenatal care, and not having enough money for necessities. A recent study in the Journal of Urban Health suggests that these other factors may be responsible for much of the tendency toward low birth weight (which, in turn, is associated with poorer infant health) that has been attributed to the use of marijuana or other drugs.

In this study, conducted with patients at Johns Hopkins Hospital in Baltimore, women who used marijuana, cocaine, or opiates were much more likely to also suffer stress and depression, lack money for necessities, use alcohol or cigarettes, and not have early prenatal care. Interestingly, once other drug use was taken into account, the apparent effect of marijuana on birth weight disappeared. And once the other risk factors were considered, the effect of cocaine and opiates on low birth weight was no longer significant. The researchers suggest that drug use may be more a marker of risk than an actual risk factor for low birth weight.

None of this means that using marijuana or any other drug (when not medically indicated) during pregnancy is a good idea. But it does suggest that draconian policies that criminalize women may be aiming at the wrong target, and that programs that help women access prenatal care and deal with the other problems in their lives that are putting their unborn babies at risk might do more good.