Based on our concerns regarding the negative effects of cannabis on the developing fetus, we follow the ACOG guidelines regarding the use of cannabis and other illicit/recreational drugs in pregnant and nursing women. Even for women who are using medical marijuana, we recommend that women who are pregnant or planning to conceive should discontinue marijuana use.
Some but not all studies have suggested that cannabis, used either by the mother or the father, may negatively impact fertility. Two articles listed below look at this question. Payne and colleagues review studies looking at the impact of marijuana on male infertility. In another study (Nassan et al, 2019), researchers report that cannabis use by the mother reduced the success rates from ART and increased risk of pregnancy loss. We will cover these articles in greater detail in the upcoming weeks.
Ruta Nonacs, MD PhD
PMS AND PMDD
|No articles this week|
INFERTILITY AND MENTAL HEALTH
|No articles this week|
PSYCHIATRIC ILLNESS DURING PREGNANCY
|A meta-synthesis of women’s experiences of online forums for maternal mental illness and stigma.|
Moore D, Drey N, Ayers S. Arch Womens Ment Health. 2019 Oct 24.
MEDICATIONS AND PREGNANCY
|No articles this week|
POSTPARTUM PSYCHIATRIC ILLNESS
|The role of prenatal, obstetric, and post-partum factors in the parenting stress of mothers and fathers of 9-month old infants.|
Matvienko-Sikar K, Murphy G, Murphy M. J Psychosom Obstet Gynaecol. 2018 Mar;39(1):47-55.
Mothers reported higher levels of parenting stress than fathers (p?<?0.001). Maternal parenting stress was predicted by attachment, own health status, average sleep, occupation, household income, and having a very rapid labor. Paternal parenting stress was predicted by attachment and own health status.
Cooper MC, Kilvert HS, Hodgkins P, Roskell NS, Eldar-Lissai A. CNS Drugs. 2019 Oct 22.
For the HAM-D, differences (95% CIs) between brexanolone and SSRIs were 12.79 (8.04-17.53) at day 3, 5.87 (-?1.62 to 13.37) at week 4, and 0.97 (-?6.35 to 8.30) at the last observation. For the EPDS, the differences were 7.98 (5.32-10.64) at day 3, 6.35 (3.13-9.57) at week 4 and 4.05 (0.79-7.31) at the time of last observation. These analyses suggest that brexanolone demonstrated larger differences for both patient- and clinician-reported PPD outcomes.
Parade SH, Wong K, Belair R, Dickstein S, Seifer R. Infant Behav Dev. 2019 Oct 18;
Axfors C, Bränn E, Henriksson HE, Hellgren C, Kunovac Kallak T, Fransson E, Lager S, Iliadis SI, Sylvén S, Papadopoulos FC, Ekselius L, Sundström-Poromaa I, Skalkidou A. BMJ Open. 2019 Oct 22. Free Article
This population-based, prospective Biology, Affect, Stress, Imaging and Cognition (BASIC) cohort will investigate the biopsychosocial aetiological processes involved in perinatal depression (PND) in an effort to pinpoint its predictors in order to improve early detection.
MEDICATIONS AND BREASTFEEDING
|No articles this week|
PERINATAL SUBSTANCE USE DISORDERS
|Cannabis and Male Fertility: A Systematic Review.|
Payne KS, Mazur DJ, Hotaling JM, Pastuszak AW. J Urol. 2019 Mar 27
Research supports a role for cannabis in reducing sperm count and concentration, inducing abnormalities in sperm morphology, reducing sperm motility and viability, and inhibiting capacitation and fertilizing capacity. Animal models demonstrate a role for cannabis in testicular atrophy and reduced libido and sexual function, but these results have not yet been replicated in human studies. Studies examining hormonal changes suggest inconclusive effects on testosterone levels, lowered luteinizing hormone (LH) levels, and unchanged follicle stimulating hormone (FSH) levels.
Nassan FL, Arvizu M, Mínguez-Alarcón L, Gaskins AJ, Williams PL, Petrozza JC, Hauser R, Chavarro JE; EARTH Study Team. Hum Reprod. 2019 Sep 29;34(9):1818-1829.
Even though marijuana smoking has not been found in past studies to impact the ability to become pregnant among pregnancy planners in the general population, it may increase the risk of pregnancy loss among couples undergoing infertility treatment. Marijuana smoking by females and males may have opposing effects on outcomes of infertility treatment with ART.
MATERNAL MENTAL HEALTH AND CHILD OUTCOMES
|Postpartum-specific anxiety and maternal bonding: Further evidence to support the use of childbearing specific mood tools.|
Fallon V, Silverio SA, Halford JCG, Bennett KM, Harrold JA. J Reprod Infant Psychol. 2019 Oct 23:1-11.
Higher levels of postpartum specific anxiety were associated with impaired overall bonding scores, specifically impaired general bonding and higher levels of rejection, anger, and infant focused anxieties.
Fallon VM, Harrold JA, Chisholm A. Matern Child Nutr. 2019 Jul. Review
Current delivery of UK Baby Friendly Initiative (BFI) may promote unrealistic expectations of breastfeeding, not meet women’s individual needs, and foster negative emotional experiences. These findings reinforce conclusions that the current approach to BFI needs to be situationally modified in resource-rich settings.
Nath S, Pearson RM, Moran P, Pawlby S, Molyneaux E, Howard LM. Soc Psychiatry Psychiatr Epidemiol. 2019 Oct 23.
Mothers with disordered personality traits did not perceive themselves as having bonding impairments with their infants but were less sensitive during observed interactions, though depressive symptoms attenuated this relationship.
MENOPAUSE AND MENTAL HEALTH
|Does mid-life aging impact women’s sleep duration, continuity, and timing?: A longitudinal analysis from the Study of Women’s Health Across the Nation.|
Matthews KA, Kravitz HM, Lee L, Harlow SD, Bromberger JT, Joffe H, Hall MH. Sleep. 2019 Oct 21.
Sleep may not worsen in general in midlife women. Perhaps the expected negative effect of aging in midlife into early old age on sleep is overstated.
Thurston RC, Chang Y, Buysse DJ, Hall MH, Matthews KA. Sleep. 2019 May 31.
Among these women who underwent objective measurement of sleep and hot flashes, nocturnal wakefulness was observed with the majority of hot flashes.
Crawford SL, Crandall CJ, Derby CA, El Khoudary SR, Waetjen LE, Fischer M, Joffe H. Menopause. 2018 Dec 21;26(6):588-597.
Immediate post-WHI recommendations for menopausal hormone therapy (MHT) use were widely adopted. MHT risks documented in older women, however, may have led younger symptomatic women to forgo MHT for symptom relief.
Maki PM, Kornstein SG, Joffe H, Bromberger JT, et al. Menopause. 2018 Oct;25(10):1069-1085.
OTHER TOPICS IN WOMEN’S MENTAL HEALTH
|Depressive Symptoms Predict Change in Telomere Length and Mitochondrial DNA Copy Number Across Adolescence.|
Humphreys KL, Sisk LM, Manczak EM, Lin J, Gotlib IH. J Am Acad Child Adolesc Psychiatry. 2019 Oct 16.
Several studies have found associations between a diagnosis or symptoms of major depressive disorder and markers of cellular aging and dysfunction. These investigations, however, are predominantly cross-sectional and focus on adults. In this study, researchers used a prospective longitudinal design to test the cross-sectional association between depressive symptoms in adolescents and telomere length (TL) as well as mitochondrial DNA copy number (mtDNA-cn). Depressive symptoms precede changes in cellular aging and dysfunction, rather than the reverse.