Are nicotine replacement products safe in pregnancy?
Publication Date:20/08/2008
What’s the best way to give up smoking if you’re pregnant or planning a pregnancy? Many doctors recommend nicotine patches, gum or sprays, but there have been doubts about whether these can affect unborn babies. A new study provides reassurance about one of the possible risks.
What do we know already?
We know that smoking during pregnancy can harm your unborn baby. It increases the chances of having a miscarriage (when the pregnancy is lost before 20 weeks) or a stillbirth (where the baby dies before being born).
Because smoking is so harmful to babies, doctors encourage women to give up smoking when they find out they're pregnant, or better still, when they start trying for a baby. But many women find it hard to quit.
Doctors have been unsure whether it’s a good idea to recommend nicotine replacement therapy (NRT) to help women quit during pregnancy. Nicotine replacement therapy uses patches, gum or sprays to give you a small dose of nicotine, which helps fight the cravings while you’re giving up.
Some previous studies have shown that NRT might affect the way babies’ bones develop. This new study examined what happened to almost 90,000 pregnant women and their babies, to see whether NRT made a difference to the women's chances of having a stillbirth.
What does the new study say?
Women who took NRT during their pregnancy were no more likely to have a stillbirth than women who didn’t take NRT. Even women who still smoked while taking NRT had a lower risk of stillbirth than smokers who didn’t take NRT, possibly because they were smoking less.
Tell me more about the study’s findings
Here are some figures from the study:
- Looking at all of the women in the study together, there were 5.7 stillbirths for every 1,000 births
- Looking just at women who used NRT, there were 4.2 stillbirths for every 1,000 births
- Looking just at women who smoked, but didn’t use NRT, there were 8 stillbirths for every 1,000 births.
So, using NRT almost halved the chances of having a stillbirth, compared with not using NRT and continuing to smoke.
Where does the study come from?
The study was carried out by researchers in Denmark, and published in the British Journal of Obstetrics and Gynaecology, owned by Blackwell Publishing. It was funded by the Danish Ministry of Health.
How reliable are the findings?
Studies like this can only give us a broad picture. They can’t tell us whether NRT actually reduces the chances of having a stillbirth. That’s because other things also affect the risk. For example, women smokers who decided to use NRT might be more health-conscious generally than women who didn’t use NRT. They might be more careful about other things, like eating well and drinking less alcohol.
But it’s a big study, which was carefully carried out. It’s probably safe to rely on the main finding, that NRT doesn’t increase women’s chances of having a stillbirth. We still need more research to see whether NRT has an effect on other risks, like miscarriages or the way babies grow.
What does this mean for me?
If you’re pregnant, it’s really important to give up smoking. But many women find this hard to do. The new study shows that it’s probably better to use NRT to help yourself quit, rather than just to carry on smoking.
What should I do now?
If you are pregnant, or planning a pregnancy, now is a great time to quit smoking. Talk to your doctor, midwife or pharmacist about how best to do it. They’ll be delighted to help you.
From:
Strandberg-Larsen K, Tinggaard M, Nybo Andersen A-M, et al. Use of nicotine replacement therapy during pregnancy and stillbirth: a cohort study. BJOG. Published online 21 August 2008.
To find out more about how best to give up cigarettes, see our information on smoking.
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This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
