D Serebrisky / Efectos de la marihuana sobre la salud miento, particularmente luego de controlar la exposición prenatal a otras drogas (Day N et al. 1992; Fried PA. 1991; English DR, 1997; Eyler FD 1998). • No se han observado síntomas de abstinencia en fetos expuestos a marihuana, a pesar de que se reportó cierto comportamiento anormal, similar al que se asocia a la exposición a otras sustancias (Fried PA, Makin JE. 1987). La exposición a marihuana se asocia con un aumento de los sobresaltos y temblores en los recién nacidos (Fried PA. 1991). • La marihuana tiene afinidad por los lípidos y se acumula en la leche materna (Jakubovic A et al. 1974). • La Asociación Americana de Pediatría considera que el uso de marihuana, opiáceos, cocaína y anfetaminas es una contraindicación para el amamantamiento. • En niños de 10 años que han sido expuestos a marihuana prenatal se asocia a inatención e impulsividad (Goldschmidt L et al. 2000). • La marihuana parece no afectar el CI pero ha sido asociada a déficit en la resolución de problemas, atención sostenida y la memoria visual, análisis e integración (Fried PA. 2002; Fried PA, et al. 2003; Fried PA et al. 1998; Fried PA, Smith AM. 2001; Fried PA, Watkinson B. 2001) y con déficit en el aprendizaje y la memoria (Richardson GA et al. 2002). • La exposición prenatal a marihuana ha sido asociada a un aumento del riesgo de convertirse en fumador tanto de marihuana como de tabaco (Porath AJ et al. 2005). Bibliografía • Abrams RM, Cook CE, Davis KH, Niederreither K, Jaeger MJ, Szeto HH. (1985-1986) Plasma delta- 9tetrahydrocannabinol in pregnant sheep and fetus after inhalation of smoke from amarijuana cigarette. Alcohol Drug Res; 6(5):361–369. • Adolescent exposure to cannabinoids induces long-lasting changes in the response to drugs of abuse of rat midbrain dopamine neurons. Biol Psychiatry 56:86–94. • American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, American Psychiatric Association, Washington, DC. • Bachman JG, Wadsworth KN, O’Mally PM, et al. (1997). Smoking, drinking and drug use in young adulthood. Malwah, New Jersey: Lawrence Erlbaum Associates. EDITORIAL SCIENS 53
D Serebrisky // Trastornos por sustancias - Marihuana • Bailey JR, Cunny HC, Paule MG, Slikker W Jr. (1987). Fetal disposition of delta9-tetrahydrocannabinol (THC) during late pregnancy in the rhesus monkey. Toxicol Appl Pharmacol; 90(2):315–321. • Bramness, J. G., H. Z. Khiabani, Mørland J (2010). Impairment due to cannabis and ethanol: clinical signs and additive effects. Addiction 105(6): 1080-7. • Brookhoff, D., Cook, C.S. & Mann, C.S. (1994). Testing reckless drivers for cocaine and marijuana. New England Journal of Medicine, 331: 518-522. • Chiriboga CA. (2003). Fetal alcohol and drug effects. Neurologist;9(6):267–279 • Dalterio SL. (1986). Cannabinoid exposure: effects on development. Neurobehav Toxicol Teratol; 8(4):345–352. • Day N, Cornelius M, Goldschmidt L, Richardson G, Robles N, Taylor P. (1992) The effects of prenatal tobacco and marijuana use on offspring growth from birth through 3 years of age. Neurotoxicol Teratol; 14(6):407–414. • Ehrenreich H, Rinn T, Kunert HJ, et al. Specific attentional dysfunction in adults following early start of cannabis use. Psychopharmacology (Berl). 1999; 142:295–301. • English DR, Hulse GK, Milne E, Holman CD, Bower CI. (1997) Maternal cannabis use and birth weight: a meta-analysis. Addiction; 92(11):1553–1560. • Eyler FD, Behnke M, Conlon M, Woods NS, Wobie K. (1998) Birth outcome from a prospective, matched study of prenatal crack/cocaine use: I. Interactive and dose effects on health and growth. Pediatrics; 101(2):229–237. • Fergusson, D. M., Horwood, J. & Swain-Campbell, N. (2002) Cannabis use and psychosocial adjustment in adolescence and young adulthood. Addiction, 97, 1123– 1135. • Fisher SE, Atkinson M, Chang B (1987). Effect of delta-9-tetrahydrocannabinol on the in vitro uptake of alpha-aminoisobutyric acid by term human placental slices. Pediatr Res; 21(1):104–107. • Fried PA, Makin JE. (1987) Neonatal behavioural correlates of prenatal exposure to marihuana, cigarettes and alcohol in a low risk population. Neurotoxicol Teratol; 9(1):1–7. • Fried PA, Smith AM. (2001) A literature review of the consequences of prenatal marihuana exposure. An emerging theme of a deficiency in aspects of executive function. Neurotoxicol Teratol; 23(1):1–11. • Fried PA, Watkinson B, Gray R. (1998) Differential effects on cognitive functioning in 9- to 12-year olds prenatally exposed to cigarettes and marihuana. Neurotoxicol Teratol; 20(3):293–306. • Fried PA, Watkinson B, Gray R. (2003) Differential effects on cognitive functioning in 13- to 16-yearolds prenatally exposed to cigarettes and marihuana. Neurotoxicol Teratol; 25(4):427–436. • Fried PA, Watkinson B. (2001) Differential effects on facets of attention in adolescents prenatally exposed to cigarettes and marihuana. Neurotoxicol Teratol; 23(5):421–430. • Fried PA. (1991) Marijuana use during pregnancy: consequences for the offspring. Semin Perinatol;15(4):280–287. • Fried PA. (2002) Adolescents prenatally exposed to marijuana: examination of facets of complex behaviors and comparisons with the influence of in utero cigarettes. J Clin Pharmacol; 42(suppl 11):97S–102S. • Goldschmidt L, Day NL, Richardson GA (2000). Effects of prenatal marijuana exposure on child behavior problems at age 10. Neurotoxicol Teratol; 22(3):325–336. • Grotenhermen F. (2003). Pharmacokinetics and pharmacodynamics of cannabinoids. Clin Pharmacokinet;42:327-60. 54
