From the Guidelines
Nicotine use during pregnancy is strongly associated with adverse birth outcomes, including low birth weight, preterm delivery, and stillbirth. According to recent studies 1, smoking during pregnancy reduces fetal growth, increases the risk of preterm birth, and doubles the risk for delivering an infant with low birth weight. The relative risk for stillbirth death is also increased by 25% to 50%.
Key Effects of Nicotine Use During Pregnancy
- Reduced fetal growth: Nicotine use during pregnancy can reduce fetal growth, leading to low birth weight and other complications 1.
- Increased risk of preterm birth: Nicotine use during pregnancy increases the risk of preterm birth, which can lead to a range of health problems for the baby 1.
- Increased risk of stillbirth: Nicotine use during pregnancy increases the relative risk for stillbirth death by 25% to 50% 1.
Recommendations for Pregnant Women
Pregnant women who smoke or use nicotine replacement therapy (NRT) products should be closely monitored and advised to quit as soon as possible. While there is limited evidence on the effectiveness of NRT for smoking cessation in pregnant women 1, it may be considered for those who require medication-assisted cessation, but only under the guidance of a healthcare provider and after a thorough risk-benefit assessment. However, the USPSTF identified no studies on bupropion SR or varenicline pharmacotherapy for tobacco smoking cessation during pregnancy 1.
From the Research
Effects of Nicotine Use During Pregnancy
- Nicotine use during pregnancy has been associated with various adverse outcomes, including low birth weight, preterm birth, and congenital anomalies 2, 3, 4.
- Studies have shown that nicotine replacement therapy (NRT) may be effective in reducing the risk of these adverse outcomes, but the evidence is not conclusive 2, 5.
- The use of electronic cigarettes (ECs) during pregnancy has been linked to an increased risk of preterm birth and low birth weight, and quitting EC use has been shown to reduce this risk 3.
- Nicotine exposure during pregnancy has been shown to have long-term effects on the health and development of the child, including impaired function of various bodily systems and increased risk of behavioral problems 4.
Adverse Outcomes Associated with Nicotine Use
- Low birth weight: Nicotine use during pregnancy has been associated with an increased risk of low birth weight, which can have long-term effects on the health and development of the child 2, 3, 4.
- Preterm birth: Nicotine use during pregnancy has been linked to an increased risk of preterm birth, which can increase the risk of various health problems for the child 2, 3, 4.
- Congenital anomalies: Some studies have suggested that nicotine use during pregnancy may increase the risk of congenital anomalies, although the evidence is not conclusive 2, 4.
Safety of Nicotine Replacement Therapy
- The safety of NRT during pregnancy is a topic of ongoing debate, with some studies suggesting that it may be effective in reducing the risk of adverse outcomes, while others have raised concerns about its potential effects on the fetus 2, 5.
- Faster-acting NRT formulations may be safer and more beneficial for the offspring than slower-acting formulations 5.
- However, NRT is not completely harmless, and its use during pregnancy should be carefully considered and monitored 5.