Smoking in pregnancy and lactation: a review of risks and cessation strategies
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Despite documented evidence of harm to fetus and infant, a substantial number of women continue to smoke during pregnancy and lactation.
To examine the literature regarding smoking during pregnancy and breastfeeding to ascertain adverse effects as well as the efficacy of interventions to enable women to stop smoking in the perinatal period.
A comprehensive literature search was undertaken to identify all published studies reporting on smoking in pregnancy and lactation. MEDLINE, EMBASE, PUBMED, and Web of Science databases were searched for studies published in English from 1966 to 2008 that reported on smoking in pregnancy and breastfeeding, with information on adverse effects and on all forms of smoking cessation, including behavioral interventions, nicotine replacement therapy, and pharmacotherapy such as antidepressants.
There is evidence that smoking in pregnancy and lactation may cause many adverse affects in the perinatal period, childhood, and up to adulthood. These adverse effects include infertility, ectopic pregnancy, spontaneous abortion, placenta insufficiency, low birth weight, fetal growth restriction, preterm delivery, orofacial clefts, SIDS, craniosynostosis, clubfoot, childhood respiratory disease, attention deficit disorder, and some childhood cancers. A number of strategies have been developed to assist pregnant women in quitting smoking, including both behavioral interventions and pharmacological therapies, such as nicotine replacement and antidepressant therapy.
Behavioral interventions report only modest success rates. Nicotine replacement therapy and antidepressants appear to be safe to use in pregnancy, but do not achieve a substantially higher success rate for quitting.
KeywordsSmoking Pregnancy Nicotine Cessation
- 3.U.S. Department of Health and Human Services (2002) Health, United States, with chart books and trends in the health of Americans (DHHS Publication No. 1232). U.S Department of Health and Human Services Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MDGoogle Scholar
- 5.National Board of Health Denmark (2002) Survey of smoking habits in Denmark 2002. National Board of Health Denmark, CopenhagenGoogle Scholar
- 6.Statistics Sweden (2002) Swedish survey of living conditions. Statistics Sweden, StockholmGoogle Scholar
- 10.Baska T, Sovinova H, Nemeth A, Przewozniak K, Warren C, Kavcova E (2006) Czech Republic, Hungary, Poland and Slovakia GYTS Collaborative Group. Findings from the Global Youth Tobacco Survey (GYTS) in Czech Republic, Hungary, Poland and Slovakia – smokig initiation, prevalence of tobacco use and cessation. Soz Praventiv Med 51:110–116CrossRefGoogle Scholar
- 19.Collet M, Beillard C (2005) Consequences of smoking on fetal development and risk of intra-uterine growth retardation or in utero fetal death. J Gynecol Obstet Biol Reprod (Paris) 34 (Spec No 1):3S135-45Google Scholar
- 26.Langley K, Rice F, van den Bree MB, Thapar A (2005) Maternal smoking during pregnancy as an environmental risk factor for attention deficit hyperactivity disorder behaviour. A review. Minerva Pediatr 57(6):359–371Google Scholar
- 33.Lumley J, Oliver SS, Chamberlain C, Oakley L (2004) Interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev (4):CD001055Google Scholar
- 47.Hughes JR, Stead LF, Lancaster T (2007) Antidepressants for smoking cessation. Cochrane Database Syst Rev (1):CD000031Google Scholar
- 48.U.S. Food and Drug Administration Center for Drug Evaluation and Research (1997) Zyban® (bupropion) label and approval history. http://www.fda.gov/cder/drugsatfda/datafiles/default.htm. Accessed 18 Nov 2007
- 52.Krupp P, Monka C (1987) Bromocriptine in pregnancy: safety aspects. J Molec Med 65(17):823–827Google Scholar
- 55.Murtagh J, Foerster V (2007) Nicotine vaccines for smoking cessation. Issues Emerg Health Technol 103:1–4Google Scholar