Smoking and pregnancy
DOI:
https://doi.org/10.25118/2236-918X-7-2-4Keywords:
Pregnancy, smoking, treatmentAbstract
The literature is consistent in confirming the harmful effects of smoking in the general population and especially in pregnant women. Smoking during pregnancy is a predictor of adverse birth outcomes, such as preterm birth and low birth weight, as well as of increased fetal and infant mortality. Smoking cessation should always be stimulated in pregnant women. To increase treatment success, it is important to consider social vulnerabilities, associated diseases (especially depression and anxiety), emotional maturity, whether or not the pregnancy was desired, and uncertainties about the future. The objectives of this article were to identify the pregnant women who are more vulnerable to continue smoking during pregnancy, to provide guidance on the management of these cases, evaluating the availability of treatments that can be used safely during pregnancy, and to identify the best treatment to offer to these women. Currently, behavioral therapy, especially cognitive behavioral therapy, is the best treatment available for smoking cessation, both for pregnant women and in general. Severe nicotine dependence may require pharmacotherapy. In these cases, the medication most commonly used is bupropion, despite the lack of evidence regarding its safety for the fetus. In clinical practice, no complications for the fetus or for the pregnant women have been reported.
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U.S. Department of Health Educati on and Welfare. Smoking and health: report of the advisory committ ee of the surgeon general of the public health service. Washington: U.S. Public Health Service; 1964.
Coleman T, Chamberlain C, Davey MA, Cooper SE, Leonardi-Bee J. Pharmacological interventi ons for promoti ng smoking cessati onduring pregnancy. Cochrane Database Syst Rev. 2012;(9):CD010078.
Haggasträm FM. Diretrizes para cessação do tabaco. Abordagem de grupos especiais: gestantes. J Bras Pneumol. 2004;30:55-7.
Haddad A, Davis AM. Tobacco smoking cessation in adults and pregnant women: behavioral and pharmacotherapy interventions. JAMA. 2016;315:2011-2.
Curtin SC, Mathews TJ. Smoking prevalence and cessation before and during pregnancy: data from the birth certificate, 2014. Nati Vital Stat Rep. 2016;65:1-14.
Hulman A, Lutsiv O, Park CK, Krebs L, Beyene J, McDonald SD. Are women who quit smoking at high risk of excess weight gain throughout pregnancy? BMC Pregnancy Childbirth. 2016;6:263.
Bérard A, Zhao JP, Sheehy O. Success of smoking cessation interventions during pregnancy. Am J Obstet Gynecol. 2016;215:611.e1-611.e8.
Moylan S, Gustavson K, Overland S, Karevold EB, Jacka FN, Pasco JA, et al. The impact of maternal smoking during pregnancy on depressive and anxiety behaviors in children: the Norwegian Mother and Child Cohort Study. BMC Med. 2015;13:24.
Fallin A, Miller A, Assef S, Ashford K. Perceptions of electronic cigarettes among medicaid-eligible pregnant and postpartum women. J Obstet Gynecol Neonatal Nurs. 2016;45:320-5.
Tong VT, Farr SL, Bombard J, D’Angelo D, Ko JY, England LJ. Smoking before and during pregnancy among women reporting depression or anxiety. Obstet Gynecol. 2016;128:562-70.
Flemming K, Graham H, McCaughan D, Angus K, Sinclair L, Bauld L. Health professionals’ perceptions of the barriers and facilitators to providing smoking cessation advice to women in pregnancy and during the post-partum period: a systematic review of qualitative research. BMC Public Health. 2016;16:290.
Weng SC, Huang JP, Huang YL, Lee TS, Chen YH. Effects of tobacco exposure on perinatal suicidal ideation, depression and anxiety. BMC Public Health. 2016;16:623.
Taylor G, McNeill A, Girling A, Farley A, Lindson- Hawley N, Aveyard P. Change in mental health after smoking cessation: systematic review and meta-analysis. BMJ. 2014;348:g1151.
Lee M, Miller SM, Wen KY, Hui SK, Roussi P, Hernandez E. Cognitive-behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women. J Behav Med. 2015;38:932-43.
Fokina VM, West H, Oncken C, Clark SM, Ahmed MS, Hankins GD, et al. Bupropion therapy during pregnancy: the drug and its major metabolites in umbilical cord plasma and amniotic fluid. Am J Obstet Gynecol. 2016;215:497.
Vaz LR, Aveyard P, Cooper S, Leonardi-Bee J, Coleman T, SNAP Trial Team. The association between treatment adherence to nicotine patches and smoking cessation in pregnancy: a secondary analysis of a randomized controlled trial. Nicotine Tob Res. 2016;18:1952-9.
Fokina VM, Xu M, Rytting E, Abdel-Rahman SZ, West H, Oncken C, et al. Pharmacokinetics of bupropion and its pharmacologically active metabolites in pregnancy. Drug Metab Dispos. 2016;44:1832-8.
Wigginton B, Gartner C, Rowlands IJ. Is it safe to vape? Analyzing online forums discussing e-cigarette use during pregnancy. Womens Health Issues. 2017;27:93-9.
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