Nicotine replacement seen as safe and effective in pregnancy

NEW ORLEANS (Reuters Health) – Pregnant women who use nicotine patches are more likely to succeed at smoking cessation, without any compromise to fetal well-being, according to Dr. Paul L. Ogburn, Jr., speaking here at the 22nd annual meeting of the Society for Maternal-Fetal Medicine.

"This study helps to remove the fear some physicians have of using the nicotine patch in pregnant women," Dr. Ogburn, director of maternal-fetal medicine at State University of New York at Stonybrook, told Reuters Health. "There's been a suspicion that the nicotine patch was better for fetuses than smoking, and this study helps substantiate that belief pattern."

In a small study, he and his colleagues followed 21 pregnant women who had continued to smoke more than 15 cigarettes daily into the third trimester of pregnancy. The subjects received 22 mg of nicotine daily through nicotine replacement therapy patches.

The women were followed weekly until delivery; the investigators monitored fetal growth and well being by ultrasound imaging and non-stress tests. The subjects were monitored by the measurement of exhaled carbon monoxide at each visit and at delivery.

By the time the subjects gave birth, eight (38%) were abstaining from the use of cigarettes, compared to the typical smoking cessation rates of 4.9% to 31.9% for pregnant women.

The gestational ages of the infants at delivery ranged from 36.3 to 41.1 weeks. Birth weights ranged 2400 to 4400 g [??b/u hard to read??], with no birth weights less than the 10% percentile.

Physicians need to let the woman make the call regarding whether she can quit without nicotine replacement or whether she needs the patch, Dr. Ogburn told Reuters Health.

"It's difficult to stop smoking anyway, and women who are pregnant and smoke know they shouldn't smoke," he said. "Those who continue are obviously highly addicted to cigarettes. If a woman can successfully quit smoking without the patch, she should. If not, she should use the patch. You need to let the woman decide, because in reality you have no other option. You might as well serve as her advocate and cheerleader."

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