Nicotine Replacement Therapy for Smoking Cessation During Pregnancy

Smoking at anytime is a harmful habit but during pregnancy it can affect the baby’s health as well. Smoking has been linked to slow fetal growth, an increased risk of premature birth, and an increase in rates of health problems in infancy including death. The sooner a pregnant woman stops smoking the better. Nicotine replacement therapy (NRT), with patches or gums, is a common method to help quit smoking. However, nicotine is a class D pregnancy drug. This means that it is dangerous for the developing baby, but it may be less risky than continued smoking. Nicotine found in cigarettes and NRT, has been linked to an increase in the rates of stillbirths.

The National Institute of Public Health in Denmark reviewed the records of stillbirths. The results published in the British Journal of Gynecology indicated that although smoking was associated with an increased risk of stillbirths, nicotine replacement therapy was not.

About the Study

The cohort study reviewed 495 cases of stillbirths. A death was considered a stillbirth if the pregnancy was beyond 20 weeks. Out of all the cases, eight were from women that had used NRT. When compared to nonsmoking women that did not use NRT:

  • NRT use was not associated with higher risk of stillbirths
  • Women that smoked had an increased risk of stillbirth
  • Women that smoked and used NRT had an increased risk but lower than that of smokers

How Does This Affect You?

Smoking is harmful to you and your baby. It is best to stop before becoming pregnant. If you are already pregnant, the sooner you stop the better the outcome. There are several options and support systems to help you quit smoking. While NRT has been shown to be helpful it is not the best option for pregnant women. It should only be used if no other method helps and with your doctor's guidance.

If you smoke, talk to your doctor about methods to help you quit. If you are already pregnant, talk to your doctor before starting a nicotine replacement therapy.



Strandberg-Larsen K, Tinggaard M, Nybo Anderson AM, Olsen J, Gronbaek M. Use of nicotine replacement therapy during pregnancy and stillbirth: a cohort study. BJOG . 2008 Oct;115(11):1405-10. Epub 2008 Aug 20.
Last reviewed February 2009 by Larissa J. Lucas, MD

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