Smoking and smoking cessation in pregnancy

Abstract

Key content A 2005 survey of new mothers in England revealed that the prevalence of smoking among pregnant women remains high. Smoking remains the single largest preventable cause of fetal and infant morbidity in the UK. Potential problems during pregnancy include ectopic pregnancy, miscarriage, placental complications, premature rupture of membranes, premature birth and fetal growth restriction. Counselling sessions are effective in pregnancy and lead to a reduction in the incidence of preterm birth and low birthweight. Nicotine replacement therapy can be considered in pregnant women under some circumstances, whilst current evidence suggests other pharmacological therapies are contraindicated. Learning objectives To understand the risks of smoking to fetal and child health. To understand epidemiological factors and implications for smoking cessation services. To become familiar with the recommended smoking cessation methods offered during pregnancy. Ethical issues Nicotine crosses the placenta and has been shown to cause a dose‐related rise in maternal blood pressure and heart rate. Some argue that use of nicotine replacement therapy unnecessarily exposes the fetus to health risks. Please cite this article as: Eastham R, Gosakan R. Smoking and smoking cessation in pregnancy. The Obstetrician & Gynaecologist 2010;12:103–109.