Impact of the use of cannabis as a medicine in pregnancy, on the unborn child: a systematic review and meta-analysis protocol

IntroductionThe use of cannabis for medicinal purposes is on the rise. As more people place their trust in the safety of prescribed alternative plant-based medicine and find it easily accessible, there is a growing concern that pregnant women may be increasingly using cannabis for medicinal purposes to manage their pregnancy symptoms and other health conditions. The objectives of this scoping review are to: conduct a systematic search of the literature to investigate the use of cannabis as a medicine in the context of the recent legislative changes and the resulting increase in use and acceptance, specifically in pregnancy; describe the characteristics of the demographic population using cannabis for medicinal purposes during pregnancy; and to map evidence of its impact on the unborn child and on the child up to twelve months postpartum. Methods and analysesResearch on pregnant women who use cannabis for medicinal purposes only, and infants up to one year after birth who experienced in utero exposure to cannabis for medicinal purposes, will be included in this review. Reviews, randomised controlled trials, case-control, cross-sectional and cohort studies, that have been peer reviewed and published between 1996 and April 2024 as a research paper that investigates prenatal use of cannabis for medicinal purposes and foetal, perinatal, and neonatal outcomes, will be selected for review. Excluding cover editorials, letters, commentaries, protocols, conference papers and book chapters. Effects of illicit drugs use, alcohol misuse and nicotine exposure on neonate outcome will be controlled by excluding studies reporting on the concomitant use of such substances when cannabis data cannot be isolated. All titles and abstracts will be reviewed by one researcher. Records will be excluded based on title and abstract screening as well as publication type. The full text articles will then be reviewed independently by at least two researchers. Where initial disagreement exists between reviewers regarding the inclusion of a study, team members will review disputed articles status until consensus is gained. Selected studies will then be assessed by at least two independent researchers for risk bias assessment using validated tools. Two researchers will pilot-test the data extraction form and independently screen the literature and extract the data. Data will be extracted and synthesised following a systematic review methodology and reported in accordance with the PRISMA guidelines to facilitate transparent reporting [1].