Document Detail


Nicotine replacement therapy effect on pregnancy outcomes.
MedLine Citation:
PMID:  20978216     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To review data assessing the effects of nicotine replacement therapy (NRT) during pregnancy on fetal, neonatal, and maternal outcomes.
DATA SOURCES: A literature search of PubMed (1966-July 2010) was performed using the terms smoking, smoking cessation, pregnancy, and nicotine replacement therapy. Bibliographies and the Cochrane Database were reviewed to identify additional relevant articles.
STUDY SELECTION AND DATA EXTRACTION: All studies including humans and published in English with data describing NRT effects on pregnancy outcomes or malformations as a primary or secondary outcome were evaluated.
DATA SYNTHESIS: Currently, behavior modification therapy is recommended for smoking cessation in pregnancy as first-line treatment, but NRT should be offered to patients who are not successful. NRT is currently a pregnancy category D medication. Pregnancy outcomes and malformation rates for NRT in pregnancy were evaluated as either primary or secondary outcomes in several trials. Four studies examined pregnancy outcomes after a full course of nicotine gum or patch therapy. NRT use significantly decreased the risk of preterm delivery and low birth weight compared to that of smokers. Only 1 study evaluated the risk of malformations after exposure to the NRT patch during the first trimester. In a retrospective analysis, NRT users had an increased risk for any fetal malformation but not for major or musculoskeletal ones. However, no adjustments were made for many known factors associated with malformations.
CONCLUSIONS: Behavior modification therapy should always be the first method tried for smoking cessation in the pregnant population. If behavior modification therapy is attempted without success, NRT should be offered because of decreased risk for low birth weight and preterm delivery compared to continued smoking. Additionally, NRT does not appear to increase the risk for malformations.
Authors:
Alicia B Forinash; Jamie M Pitlick; Kylie Clark; Valerie Alstat
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Publication Detail:
Type:  Journal Article     Date:  2010-10-26
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  44     ISSN:  1542-6270     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1817-21     Citation Subset:  IM    
Affiliation:
Department of Pharmacy Practice, St. Louis College of Pharmacy, MO, USA. aforinash@stlcop.edu
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