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Does the Use of Nicotine Replacement Therapy During Pregnancy Affect Pregnancy Outcomes?

Does the Use of Nicotine Replacement Therapy During Pregnancy Affect Pregnancy Outcomes? Objectives Although nicotine replacement therapies (NRT) may assist with smoking cessation, little is known about the safety of NRT use during pregnancy. Our purpose was two-fold: to determine characteristics of women prescribed or recommended NRT during pregnancy and to investigate whether NRT prescription/recommendation was associated with adverse pregnancy outcomes using data from the 2004 Pregnancy Risk Assessment Monitoring System. Methods Smoking and NRT referral was self-reported by 5,716 women. Information on pregnancy outcomes was obtained from birth certificates. Multivariate logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results Smokers <35 years of age and of Hispanic, Non-Hispanic Black, and Asian/Pacific Islander race/ethnicity were less likely to be prescribed or recommended NRT during pregnancy. After adjustment for age, marital status, education, and race/ethnicity, women recommended NRT had twice the risk of low birthweight as compared to nonsmokers (OR = 1.95, 95% CI: 1.10, 3.46) while smokers had 1.31 times the risk of low birthweight (95% CI: 0.92, 1.87). Results for preterm birth were similar after adjustment for the same confounding variables (NRT: OR = 2.04, 95% CI: 1.14, 3.63 and smoking: OR = 1.09, 95% CI: 0.74, 1.61). Conclusions Risks of low birthweight and preterm birth were highest for women prescribed or recommended NRT. These findings may be related to frequency of maternal smoking. While heavier smokers may be more likely to be recommended NRT, they also may have the most difficulty with cessation. Greater efforts should be made to ensure that these women do successfully cease smoking. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Maternal and Child Health Journal Springer Journals

Does the Use of Nicotine Replacement Therapy During Pregnancy Affect Pregnancy Outcomes?

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Publisher
Springer Journals
Copyright
Copyright © 2008 by Springer Science+Business Media, LLC
Subject
Medicine & Public Health; Public Health; Sociology, general; Population Economics; Pediatrics; Gynecology; Maternal and Child Health
ISSN
1092-7875
eISSN
1573-6628
DOI
10.1007/s10995-008-0361-1
pmid
18478321
Publisher site
See Article on Publisher Site

Abstract

Objectives Although nicotine replacement therapies (NRT) may assist with smoking cessation, little is known about the safety of NRT use during pregnancy. Our purpose was two-fold: to determine characteristics of women prescribed or recommended NRT during pregnancy and to investigate whether NRT prescription/recommendation was associated with adverse pregnancy outcomes using data from the 2004 Pregnancy Risk Assessment Monitoring System. Methods Smoking and NRT referral was self-reported by 5,716 women. Information on pregnancy outcomes was obtained from birth certificates. Multivariate logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results Smokers <35 years of age and of Hispanic, Non-Hispanic Black, and Asian/Pacific Islander race/ethnicity were less likely to be prescribed or recommended NRT during pregnancy. After adjustment for age, marital status, education, and race/ethnicity, women recommended NRT had twice the risk of low birthweight as compared to nonsmokers (OR = 1.95, 95% CI: 1.10, 3.46) while smokers had 1.31 times the risk of low birthweight (95% CI: 0.92, 1.87). Results for preterm birth were similar after adjustment for the same confounding variables (NRT: OR = 2.04, 95% CI: 1.14, 3.63 and smoking: OR = 1.09, 95% CI: 0.74, 1.61). Conclusions Risks of low birthweight and preterm birth were highest for women prescribed or recommended NRT. These findings may be related to frequency of maternal smoking. While heavier smokers may be more likely to be recommended NRT, they also may have the most difficulty with cessation. Greater efforts should be made to ensure that these women do successfully cease smoking.

Journal

Maternal and Child Health Journal – Springer Journals

Published: May 14, 2008

References

  • Smoking during pregnancy-United States, 1990–2002
  • Nicotine replacement therapy during pregnancy
    Oncken, C.
  • Nicotine replacement prescription practices of obstetric and pediatric clinicians
    Oncken, C. A.; Pbert, L.; Ockene, J. K.; Zapka, J.; Stoddard, A.
  • The accuracy of self-report of smoking status in pregnant women
    Walsh, R. A.; Redman, S.; Adamson, L.
  • Pharmacotherapies to enhance smoking cessation during pregnancy
    Kranzler, H. R.; Oncken, C. A.
  • Risks and benefits of nicotine to aid smoking cessation in pregnancy
    Benowitz, N. L.; Dempsey, D. A.
  • Obstetricians and gynecologists’ perceptions and use of nicotine replacement therapy
    Drake, J. A.; Jordan, T.; Price, J. H.
  • Exposure to tobacco smoke in Utero and the risk of stillbirth and death in the first year of life
    Henriken, T. B.; Kesmodel, U.; Wisborg, K.; Olsen, S. F.; Secher, N. J.
  • Perinatal events associated with maternal smoking during pregnancy
    Meyers, M. B.; Jonas, B. S.; Tonascia, J. A.
  • Case studies of three pregnant smokers and their use of nicotine replacement therapy
    Hotham, E. D.; Gilbert, A. L.; Atkinson, E. R.
  • A randomized-controlled pilot study using nicotine patches with pregnant women
    Hotham, E. D.; Gilbert, A. L.; Atkinson, E. R.
  • Simulation study of confounder selection strategies
    Maldonado, G.; Greenland, S.
  • Nicotine patch use in pregnant smokers: Nicotine and cotinine levels and fetal effects
    Ogburn, P. L.; Hurt, R. D.; Croghan, I. T.; Schroeder, D. R.; Ramin, K. D.; Offord, K. P.; Moyer, T. P.
  • Nicotine replacement therapy during pregnancy
    Benowitz, N. L.
  • Nicotine replacement therapy in pregnancy: Is probably safer than smoking
    Coleman, T.; Britton, J.; Thornton, J.
  • Effects of short-term use of nicotine gum in pregnant smokers
    Oncken, C. A.; Hatsukami, D. K.; Lupo, V. R.; Lando, H. A.; Gibeau, L. M.; Hansen, R. J.
  • Accelerated metabolism of nicotine and cotinine in pregnant smokers
    Benowitz, N. L.; Jacob, P.; Dempsey, D.
  • Effects of transdermal nicotine or smoking on nicotine concentrations and maternal-fetal hemodynamics
    Oncken, C. A.; Hardardottir, H.; Hatsukami, D. K.; Lupo, V. R.; Rodis, J. F.; Smeltzer, J. S.
  • Extent of nicotine and cotinine transfer to the human fetus, placenta, and amniotic fluid of smoking mothers
    Hansen, R.; Luck, W.; Nau, H.; Steldinger, R.
  • Randomized, double blind, placebo-controlled trial of nicotine replacement therapy in pregnancy
    Kapur, B.; Hackman, R.; Selby, P.; Klein, J.; Koren, G.
  • Influence of nicotine chewing gum on fetal blood flow
    Lindblad, A.; Marsal, K.