Nicotine patch use in pregnant smokers: smoking abstinence and delivery outcomes.
OBJECTIVE
To describe smoking abstinence and fetal effects of pregnant smokers who received 8 weeks of nicotine patch therapy.


METHODS
One-sample study of 21 pregnant women smoking > or = 15 cigarettes/day during their third trimester of pregnancy despite physician advice to stop. Nicotine patch therapy (22 mg/24 h) was initiated during the first day of a 4-day in-hospital study and continued for a total of 8 weeks. Subjects returned weekly until delivery, at 4 weeks after delivery, and at 6 and 12 months after patch therapy. Fetal growth and well-being were assessed using ultrasound examinations and non-stress tests.


RESULTS
Eight of 21 subjects completed all 8 weeks of patch therapy according to the protocol. Five subjects (24%) discontinued using the nicotine patch, owing to adverse skin reactions. There were eight subjects (38%) who were biochemically confirmed abstinent from smoking at the time of delivery; of these, seven were continuously abstinent from the start of patch therapy. Centile weight for gestational age did not change significantly over time for 12 subjects with serial ultrasound measurements available at baseline, 4 weeks and 8 weeks following initiation of patch therapy. In all cases, non-stress tests remained reactive or became reassuring with observation. No significant preterm deliveries occurred (gestational ages of 36.3-41.1 weeks). Three infants suffered severe neonatal morbidity; however, these problems were unrelated to nicotine patch therapy.


CONCLUSIONS
Nicotine patch therapy has potential benefit for pregnant smokers who continue to smoke despite physician advice to stop.
Schroeder
D R
DR
Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Ogburn
P L
PL
Hurt
R D
RD
Croghan
I T
IT
Ramin
K D
KD
Offord
K P
KP
Moyer
T P
TP
D000279:Administration, Cutaneous; D000328:Adult; D005314:Embryonic and Fetal Development; D005076:Exanthema / Q000209:etiology; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005865:Gestational Age; D006801:Humans; D008297:Male; D009538:Nicotine / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D016540:Smoking Cessation / Q000379:methods*; D016216:Ultrasonography, Prenatal
D009538:Nicotine