Uporaba marihuane v nosečnosti: pregled literature - Rode, Neža (2019)
Uvod: Marihuana je ena najpogosteje uporabljenih nedovoljenih drog in njena uporaba narašča tudi med nosečnicami. Marihuana prehaja čez posteljico in v materino mleko. Namen: Namen diplomskega dela je pridobiti in analizirati podatke raziskav o vplivu marihuane na nosečnost. Potrditi ali ovreči želimo naslednje raziskovalne trditve: 1. Marihuano v nosečnosti uporablja približno 10 odstotkov žensk, ki so večinoma mlajše in imajo nižjo stopnjo izobrazbe. 2. Marihuana v nosečnosti ni povezana s pojavnostjo nosečniške sladkorne bolezni in hipertenzivnih obolenj v nosečnosti. 3. Marihuana v nosečnosti je povezana z zastojem v rasti ploda in s prezgodnjim porodom. 4. Marihuana v nosečnosti lahko pusti resne dolgoročne posledice na plodu. Namen je tudi izdelava informativnega gradiva za ženske in zdravstvene delavce. Metode dela: Narejen je bil pregled literature z deskriptivno metodo dela. Časovni okvir iskanja virov je bil od avgusta 2018 do aprila 2019. Iskanje je potekalo z naslednjimi ključnimi besedami: v angleščini marijuana in pregnancy, cannabis in pregnancy, prenatal marijuana, prenatal cannabis, effects on mother, effects on fetus. Rezultati: Pogostost uporabe marihuane v nosečnosti se giblje med dvema odstotkoma in 30 odstotki. Ženske, ki uporabljajo marihuano, so pogosto pripadnice ranljivih skupin, kot so ženske z nižjim socioekonomskim statusom, kadilke, mlajše in samske ženske. Dokazane so bile povezave med uporabo marihuane v nosečnosti in nižjo porodno težo, prezgodnjim porodom, obravnavo na oddelku za intenzivno terapijo, poporodnimi okužbami pri novorojencu in mrtvorojenostjo. Povezava med uporabo marihuane v nosečnosti in nosečniško sladkorno boleznijo in nosečniško hipertenzijo ni bila dokazana. Dolgoročne posledice na otrocih so se kazale kot kognitivne motnje ter motnje kratkoročnega spomina. Prav tako so se pokazale nekatere strukturne spremembe na možganih. Otroci mater, ki so v nosečnosti kadile marihuano, so pogosto tudi sami v dobi adolescence začeli uporabljati marihuano. Razprava in zaključek: Ženske, ki uporabljajo marihuano v nosečnosti, večinoma pripadajo ranljivim skupinam nosečnic, kar že samo po sebi lahko pusti posledice na nosečnosti in plodu, zato težko točno določimo, katere vplive ima marihuana. Uporaba marihuane se povečuje, povečuje se tudi njena potenca, zato varna meja marihuane ne more biti določena. Naloga zdravstvenih delavcev je, da izobražujemo javnost o vplivih marihuane na nosečnost in da nudimo ženskam, ki so v nosečnosti uporabljale marihuano, najboljšo možno oskrbo. Introduction: Marijuana is one of the most commonly used illegal drugs. It's usage is rising, even among pregnant women. Marijuana crosses the barriers of the placenta and the mother's milk. Purpose: The purpose of this diploma work is to access and analize the available data of marijuana effects on the mother and fetus. We aim to confirm or deny these research statements: 1. Marijuana is used in 10% of pregnant women, who are younger and less educated. 2. Marijuana in pregnancy is not related to gestational diabetes or gestational hypertension. 3. Marijuana in pregnancy is related to growth restriction of the fetus and premature labour. It is also the purpose of this diploma work to make informative handouts for medical workers and pamphlets for women. Methods: A literature review was made, with the time frame from August 2018 to April 2019. The search was conducted in English with these keywords: marijuana in pregnancy, cannabis in pregnancy, prenatal marijuana, prenatal cannabis, effects on mother, effects on fetus. Results: The usage of marijuana in pregnancy ranges fro 2-30 %. Women, who use it are often smokers, have a lower socioeconomic status, are younger and more often single. A connection between marijuana use in pregnancy and lower birth weight, premature labour, care in the NICU, infections of the newborn and stillbirth was shown. A connection between marijuana use in pregnancy and gestational diabetes and gestational hypertension was not shown. Long term effects on fetus are attention disorders, disorders in saving, processing and usage of data and disorders of short term memory. Structure of the brain is also altered. The children of mothers who used marijuana in pregnancy have started using marijuana earlier. Discussion and conclusion: Women who use marijuana in pregnancy belong to a vulnerable group of women, which can have independent effects on pregnancy and the fetus. The use of marijuana is rising, as is its potency, so a safe limit cannot be proposed. Healthcare workers play an important role in educating the public about possible effects of marijuana use in pregnancy and to provide the best possible care for women who are using marihuana during pregnancy.