Screening and Management of Smoking in Pregnancy

Abstract

Smoking in is harmful to both the mother and baby in pregnancy. Smoking cessation is strongly encouraged and needs to be approached in a sensitive manner employing patient centred care. Women should be provided with information about the risks of smoking and referred to smoking cessation services. Referral applies to smokers and ex-smokers who quit in the prior two weeks. Data was collected from smoker or ex-smoker post-natal mothers who delivered at Mater Dei Hospital and was analysed against NICE Public Health guideline (PH26) ‘Smoking: stopping in pregnancy and after childbirth’ published in 2010 and Green-top guideline no.31 ‘The Investigation and Management of the Small-for-Gestational-Age Fetus’ published in 2013. The audit included 50 post-natal smokers or ex-smokers with the majority being either smokers or ex-smokers who stopped as soon as they found out they were pregnant. There was not a single documented referral to smoking cessation services. Only 75% of smokers who smoke 11+ cigarettes daily had serial ultrasounds to monitor for SGA. Foetal outcomes were overall satisfactory with only 12% being admitted to NPICU, 10% of which belonged to mothers still smoking in pregnancy. It is essential that mothers understand the risks of smoking in pregnancy and these should be provided with the necessary information and assistance in smoking cessation. It is not enough to recommend smoking cessation but referrals and constant support should be offered.