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However, Conner is not advocating that expecting moms use this info as the green light to roll a joint and get high. "Any foreign substance that doesnʼt directly benefit maternal or fetal health should be avoided," she says. There are several reasons not to smoke marijuana. For starters, the body of evidence onwhetherornotmarijuana isharmfulto the fetusis inconsistent. Second, little has been done to research long-term risks of neurodevelopment problems – cognitive difficulties or ADHD – in babies exposed to marijuana in the womb. "Any time there isasubstance thatweʼre notsure ofthe effects on the fetus or the mother during pregnancy, unless we know of a strong benefit to using the substance, weʼd advise not to use it," says Torri Metz, an assistant professor of maternal-fetal medicine at the University of Colorado Denver. Reuters Health reported on a U.S. study which concluded that women who used both marijuana and cigarettes while pregnant delivered smaller babies, delivered earlier, experienced asthma as well as pregnancy-related hypertension (high blood pressure). The study was conducted to see what effects marijuana alone or in combination with cigarettes might have on both mother and baby.The study teamanalyzed 12,069womenwho gave birth between January 2011 and June 2015 at hospitals associated with Baylor College of Medicine. Ofthe entire group,justlessthanone percent(or106women) reported marijuana use while pregnant. Half of this number, 48, said they also smoked cigarettes while pregnant. Researchers found that women who smoked both marijuana and cigarettes were more than twice as likely as women who used neither substance to experience asthma; two and a half more times as likely to deliver prematurely; two and a half more times to have pregnancy-related high blood pressure; and nearly three times as likely to have babies with small heads or low birth weight. Additionally, the study, reported on in Reuters Health, concluded womenwho used bothsubstanceswere more likely than the others to have diabetes and high blood pressure before pregnancy. One other study conclusion is that women who usedonly tobacco during pregnancy oronly marijuana – and those who used both – were also four to seven times more likely than women who used neither to have depression or anxiety. According to NIHʼs National Institute on Drug Abuse, animal research suggests that the bodyʼs neural system receptors play a role in controlling the brainʼs maturation, particularly in the development of emotional resp onses. Thus, THC (tetrahydrocannabinol – the main mind-altering ingredient found in marijuana) exposure very early in life may negatively affect brain development. Research on rats, the NIH reports, suggests that exposure to even low concentrations of THC late in pregnancy could have profound and long-lasting consequences for both brain and behavior in offspring. Human studies have shown that some babies born to women who used marijuana during their pregnancies respond differently to visual stimuli, tremble more, and have a high-pitched cry – which would indicate problems with neurological development. NIH contends that school children prenatally exposed to marijuana are more likely to show gaps in problem-solving skills, memory and the ability to remain attentive. Medical researchers agree that more research is needed to segment marijuanaʼs specific effects from environmental factors and use of other substances by mothers. Because roughly half of U.S. pregnancies are unplanned – with the rate considerably higher for teens and young adults – many women use marijuana without knowing they are pregnant. The American College of Obstetrics and Gynecology reports that somewhere between two percent and five percent of women say they used marijuana while pregnant. And since the drug crosses the placenta, harm to the fetus is plausible although the evidence is still unreliable.A review and analysis of 31 previously published studies have found no independent connection between marijuana use and adverse births. However,there are "confounding" factorsforlow birthweight and preterm delivery with tobacco use, which is a common combination. Shayna Conner, an assistant professor in the division of maternal-fetal medicine and ultrasound at Washington University in St. Louis School of Medicine concludes that from available evidence the risk surrounding low birthweight and pretermdelivery isfromtobacco use and other factors – not from marijuana. NEGATIVE EFFECTS ARE PLAUSIBLE A DIFFERENT SCHOOL OF THOUGHT THE SMOKING GUN Effects of Marijuana Use During Pregnancy Remain Elusive

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