Furthermore, it is well known that cannabis is a “gateway drug” and the same site indicates that over 50% of new users are under the age of 18 and of these new users the drug of choice is marijuana.
Looking at pain relievers such as tylenol and ibuprofen there is no data to suggest at least in the very young group of mothers consumption of these medications has been on the rise. Clearly we have a problem with over prescription of opioid analgesics in pregnancy but to my knowledge these have not been associated with the development of gastroschisis.
What about smoking in teens?
As the graph from the CDC below demonstrates, smoking is at an all time low among US high school students. These same students are the ones having babies with gastroschisis so at first glance this doesn’t seem to be a probable cause. Are rates among low SES students showing the same decline? A shown in this link, rates even among these groups do seem to be declining as well even though level of education does show correlations with higher prevalence of smokers.
Could Increased Cannabis Use Be The Culprit?
Almost twenty years ago a surgeon mentioned to me on a rotation during my residency that he had noted an association between marijuana use and gastroschisis.
While I don’t believe this was ever published I have to admit it stuck as if it were gospel. Some years later in another conversation about a patient with gastroschisis he said with a smile that after all these years he believes the link is an association. Young mothers use more marijuana and they also have more babies with gastroschisis. What we have here now though is something a little different. The question at hand is why is gastroschisis on the rise in the same group?
Is it cannabis? It just might be but this will need some further work to tease out. If gastroschisis is caused by a vascular phenomenon and the only real rise in drug use affecting perfusion is that associated with cannabis, it might be. On the other hand this could just be another association that will not stand the test of time. I don’t have it in for cannabis and in fact believe it could one day be quite useful in Neonatology as I have written before in Marijuana Coming Soon To An NICU Near You!
What goes around comes around as the saying goes and as my colleague nears the end of his long and storied career that in the end his original observation would be proven true. I have no wish for cannabis to be linked to the increase in gastroschisis but a part of me would love to see my colleague proven right after all these years. Stay tuned!