Cannabis use and maternal fetal health: Closing the knowledge gap
Physician-scientist Jamie Lo, M.D., MCR, conducts research on the impact of chronic cannabis use on male and female reproductive health, pregnancy and offspring outcomes. In her clinical practice, she specializes in caring for women with high-risk pregnancies that include complex maternal or fetal medical issues.
Lo is associate professor of maternal fetal medicine in the OHSU School of Medicine’s Department of Obstetrics and Gynecology, and affiliate associate professor, Oregon National Primate Research Center. She is also a recipient of the OHSU Faculty Excellence and Innovation Award. We sat down with her, virtually, to talk about her work.
What led you to maternal fetal health?
In the Lab looks at the people who help make OHSU such a vibrant research institution. In each post, researchers and physician-scientists describe their current work and life as researchers.Research was always the goal for me, and, almost accidentally, medicine became an entry point for research. When I was an undergraduate studying molecular cell biology, I was introduced to medicine through volunteer work. I found that interfacing with patients really energized me — I also saw that there was a lot of potential for clinical practice and basic research to inform each other. At about the same time, I learned of programs available to support physician-scientist training, and subsequently applied to medical school.
Maternal fetal medicine is like the pluripotent stem cell of medicine. It has the capacity to develop into and combine many different disciplines — imaging, procedures, critical care, and more. It also provides rich opportunities for research that directly inform clinical practice, and for clinical experiences to drive innovation.
In the clinic, I find fulfillment in caring for critically ill patients. It’s intellectually challenging in that it involves all the body’s systems, and you are caring for two patients. Those aspects create complex cases. On a human-to-human level, working with these patients is very challenging for a number of reasons.
As with many critical care scenarios, you have to explain complex medicine in plain language really quickly. In the case of maternal fetal medicine, I am asking people to make decisions for two people. I have to make sure the mother or the representative understands the full picture. What might be better for the baby could adversely impact the mother, or vice versa. There are situations where a decision might help the patient in future pregnancies, even if the outcome in the current situation is not optimal. Even though it is difficult, I find the work and the differences I can make very fulfilling.
Tell us about your current research on cannabis
Lo with collaborators Jon Hennebold, Ph.D. (left) and Leo Han, M.D., M.P.H. (OHSU/Christine Torres Hicks)
In maternal fetal medicine, we care for high-risk patients that can have genetic risk factors and/or environmental factors. Although we can’t immediately alter their genetic risks, we can mitigate environmental factors and lifestyle behaviors like substance use.
This is an example of my clinical work informing my research. Evidence-based medicine helps us best counsel and educate our patients. While we are able to explain the complications of prenatal alcohol and tobacco exposure to the pregnancy and developing fetus, we have very limited and heterogenous data for cannabis. It was clear that we needed to bridge this gap in knowledge.
Clinicians don’t usually have the protected time or financial support for research. Funding from the Faculty Excellence and Innovation award really opened doors for me. It provided me the critical time needed to think, read, invent, write — and to collaborate.
My lab’s work has generated a lot of compelling data regarding the prenatal impact of cannabis use. It has also led to new research on the impact of chronic cannabis use on male and female fertility and reproductive health involving multi-disciplinary, multi-modal and multi-institutional collaborations. By the end of my second year of the Faculty Excellence and Innovation award funding, I have generated enough preliminary data to submit for several large NIH applications, and published several peer-reviewed publications of our findings. What is really important is that we are helping close the gap in knowledge surrounding the effects of cannabis exposure, both during pregnancy and postnatally. This work will help us provide those who are trying to conceive, are pregnant or are lactating with important safety data and empower them to make informed decisions.
What do you do when you’re not working?
I’m an avid runner. I run 10 miles a day, and that’s when I disconnect from distractions, clear my head and work through research ideas.
I also eat a lot! I love food. I also have a passion for art and am looking forward to getting back into the art studio and on the wheel, but for now I will just enjoy creating figures for grants and manuscripts.
