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Vol. 42. Issue 8.
Pages 404-409 (August 2006)
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Vol. 42. Issue 8.
Pages 404-409 (August 2006)
Review Article
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Nicotine Replacement Therapy During Pregnancy
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Carlos A. Jiménez Ruiz
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victorina@ctv.es

Correspondence: Dr. C.A. Jiménez Ruiz. Unidad Especializada en Tabaquismo. Santa Cruz de Marcenado, 9, 2.°. 28015 Madrid. España
Unidad Especializada en Tabaquismo, Dirección General de Salud Pública y Alimentación, Comunidad de Madrid, Madrid, Spain
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In spite of the fact that smoking is the main cause of obstetric morbidity and mortality, 20% of North American women smoke during pregnancy. In Spain, this figure is as high as 30% to 35%. Treating smoking addiction in these patients should be the first and most important therapeutic measure undertaken by health professionals responsible for the care of pregnant women. All experts recommend the use of nicotine replacement therapy when more conservative treatments have failed. This article reviews the indications and contraindications for nicotine replacement therapy during pregnancy as well as other issues relating to the safety of this type of treatment.

Key words:
Smoking
Pregnancy
Nicotine replacement therapy

El consumo de tabaco durante el embarazo es la principal causa de morbimortalidad obstétrica. A pesar de ello, el 20% de las mujeres norteamericanas fuman cuando están embarazadas, cifra que llega a ser de hasta el 30-35% en nuestro país. El tratamiento del tabaquismo en la mujer embarazada debe ser la primera y principal medida terapéutica que los profesionales sanitarios deben adoptar cuando prestan asistencia sanitaria a la embarazada. Todos los expertos recomiendan la utilización del tratamiento sustitutivo con nicotina en los casos en que hayan fracasado tratamientos más conservadores. A lo largo de este artículo se abordan las indicaciones y contraindicaciones del tratamiento sustitutivo con nicotina durante el embarazo, así como aspectos relativos a su seguridad de uso.

Palabras clave:
Tabaquismo
Embarazo
Tratamiento sustitutivo con nicotina
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References
[1]
S Cnattingius.
The epidemiology of smoking during pregnancy: smoking prevalence, maternal characteristics and pregnancy outcomes.
Nicotine Tob Res, 6 (2004), pp. 125-140
[2]
US Department of Health and Human Services. Patterns of tobacco use among women and girls. In: Women and smoking. A report of the surgeon general. Rockville MD: US Department of Health and Human Services. Centres for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion. Office of Smoking and Health; 2001. p. 19176.
[3]
TV Russell, MA Crawford, LL Woodby.
Measurements for active cigarette smoke exposure in prevalence and cessation studies. Why simple asking pregnant smokers isn't enough.
Nicotine Tob Res, 6 (2004), pp. 141-152
[4]
M Jane, H Pardell, E Saltó, L Salleras.
Epidemiología del tabaquismo femenino. Factores determinantes de la iniciación y del mantenimiento.
Prev Tab, 3 (2001), pp. 147-154
[5]
I Nerín.
El tabaquismo en la mujer: una atracción fatal.
Arch Bronconeumol, 41 (2005), pp. 360-362
[6]
M Maya Martínez, F Carrión Valero, P Pont Martínez, M Tortajada Martínez, J Marín Pardo.
Intervención mínima personalizada en el tratamiento del tabaquismo en el embarazo.
Arch Bronconeumol, 39 (2003), pp. 116
[7]
LJ Solomon, VP Quinn.
Spontaneous quitting: self initiated smoking cessation in early pregnancy.
Nicotine Tob Res, 6 (2004), pp. 203-216
[8]
DA Dempsey, NL Benowitz.
Risks and benefits of nicotine and other medications to aid smoking cessation in pregnancy.
Drug Saf, 24 (2001), pp. 277-322
[9]
NL Benowitz, DA Dempsey.
Pharmacotherapy for smoking cessation during pregnancy.
Nicotine Tob Res, 6 (2004), pp. 189-202
[10]
K Suzuki, T Horiguchi, AC Comas-Urrutia, E Mueller-Heubach, HO Morishima, K Adamsons.
Placental transfer and distribution of nicotine in the pregnant rhesus monkey.
Am J Obst Gyn, 119 (1974), pp. 253-262
[11]
W Luck, H Nau.
Exposure of the fetus, neonate and nursed infant to nicotine and cotinine from maternal smoking.
N Engl J Med, 311 (1984), pp. 672
[12]
NL Benowitz, SG Gourlay.
Cardiovascular toxicity of nicotine: implications for nicotine replacement therapy.
J Am Coll Cardiol, 22 (1997), pp. 1422-1431
[13]
R Resnik, GW Brink, M Wilkes.
Catecholamine mediated reduction in uterine blood flow after nicotine infusion in the pregnant ewe.
J Clin Invest, 63 (1979), pp. 1133-1136
[14]
K Suzuki, LJ Minei, EE Johnson.
Effect of nicotine upon uterine blood flow in the pregnant rhesus monkey.
Am J Obst Gyn, 136 (1980), pp. 1009-1013
[15]
DS Lambers, KE Clark.
The maternal and fetal physiologic effects of nicotine.
Sem Perinat, 20 (1996), pp. 115-126
[16]
JD Folts, FC Bonebrake.
The effects of cigarette smoke and nicotine on platelet thrombus formation in stenosed dog coronary arteries: inhibition with phentolamine.
Circulation, 65 (1982), pp. 465-469
[17]
NL Benowitz, GA Fitzgerald, M Wilson, Q Zhang.
Nicotine effects on eicosanoid formation and hemostatic function: comparison of transdermal nicotine and cigarette smoking.
J Am Coll Cardiol, 22 (1993), pp. 1159-1167
[18]
RL Barbieri, J Gochberg, KJ Ryan.
Nicotine, cotinine and anabasine inhibit aromatase in human trophoblast in vitro..
J Clin Invest, 77 (1986), pp. 1727-1733
[19]
E Petridou, K Panagiotopoulou, K Katsouyanni, E Spanos, D Trichopoulous.
Tobacco smoking, pregnancy estrogens and birth weight.
Epidemiology, 1 (1990), pp. 247-250
[20]
TA Slotkin, H Cho, WL Whitmore.
Effects of prenatal nicotine exposure on neuronal development. Selective actions on central and peripheral catecholamine pathways.
Brain Res Bull, 18 (1987), pp. 601-611
[21]
FJ Seidler, ED Lewin, SE Luppi, TA Stokin.
Fetal nicotine exposure ablates the ability of postnatal nicotine challenge to release norepinephrine from rat brain regions.
Brain Res, 69 (1992), pp. 288-291
[22]
ED Levin, SJ Briggs, NG Christopher, JE Rose.
Prenatal nicotine exposure and cognitive performance in rats.
Neurtox Teratol, 15 (1993), pp. 251-260
[23]
HS Sekhon, Y Jia, R Raab, A Kuriatov, JF Pankow, JA Whitset, et al.
Prenatal nicotine increases pulmonary alpha 7 nicotinic receptors expression and alters fetal lung development in monkeys.
J Clin Invest, 103 (1999), pp. 637-647
[24]
TA Stokin, SE Lapin, EC McCook, BA Lorber, FJ Sedler.
Loss of neonatal hypoxia tolerance after prenatal nicotine exposure: implications for sudden infant death syndrome.
Brain Res Bull, 38 (1995), pp. 69-75
[25]
HR Andersson, DG Cook.
Passive smoking and sudden infant death syndrome. Review of the epidemiological evidence.
Thorax, 52 (1997), pp. 1003-1009
[26]
B Dempsey, P Jacoh, NL Benowitz.
Accelerated metabolism of nicotine and cotinine in pregnant smokers.
J Pharmacol Exp Ther, 301 (2002), pp. 594-598
[27]
K Wisborg, TB Henriksen, LB Jespersen, NJ Secher.
Nicotine patches for pregnant smokers: a randomised controlled study.
Obst Gyn, 96 (2000), pp. 967-971
[28]
M Rebagliato, F Bolumar, CV Florey, M Jarvis, S Pérez-Hoyo, I Hernández-Aguado, et al.
Variations in cotinine levels in smokers during and after pregnancy.
Am J Obst Gyn, 178 (1998), pp. 568-571
[29]
CA Oncken, DK Hatsukami, VR Luppi, HA Lando, LM Gibeau, RJ Hansen.
Effects of short term use of nicotine gum in pregnant smokers.
Clin Pharmacol Ther, 59 (1996), pp. 654-661
[30]
CA Oncken, H Hardardottir, D Hatsukami, VR Lupo, JE Rodis, JS Smeltzer.
Effects of transdermal nicotine or smoking on nicotine concentrations and maternal-fetal hemodynamics.
Obst Gyn, 90 (1997), pp. 569-574
[31]
LN Wright, JM Thorp, JA Kuller, RP Shrewsbury, C Ananth, K Hartman.
Transdermal nicotine replacement in pregnancy: maternal pharmacokinetics and fetal effects.
Am J Obs Gyn, 176 (1997), pp. 1090-1094
[32]
DR Schroeder, PL Ogburn, RD Hurt, IT Crogban, KD Ramin, KP Offord, et al.
Nicotine patch use in pregnant smokers: smoking abstinence and delivery outcomes.
J Mat Pet Med, 11 (2002), pp. 100-107
[33]
M Morales Suárez, C Bille, K Christensen, J Olsen.
Smoking habits, nicotine use and congenital malformations.
Obstet Gynecol, 107 (2006), pp. 51-57
[34]
BH Kapur, P Selby, J Klein, G Koren.
Randomised double blind placebo controlled trial of nicotine replacement therapy in pregnancy.
Cur Ther Res Clin Exp, 62 (2001), pp. 274-278
[35]
CL Melvin, CA Gafney.
Treating nicotine use and dependence of pregnant and parenting smokers: an update.
Nicotine Tob Res, 6 (2004), pp. 107-124
[36]
HR Coleman, J Britton.
UK general practitioners' beliefs, attitudes and reported prescribing of nicotine replacement therapy in pregnancy.
Nicotine Tob Res, 7 (2005), pp. 541-546
[37]
DH Ershoff, TH Ashford, RL Goldenberg.
Helping pregnant women quit smoking: an overview.
Nicotine Tob Res, 6 (2004), pp. 101-106
[38]
MC Fiore, WC Bailey, SJ Cohen, SF Dorfman, MG Goldstein, ER Gritz, et al.
Treating tobacco use and dependence. Clinical practice guideline, US Department of Health and Human Services. Public Health Service, (2000),
[39]
R West, A McNeill, M Raw.
Smoking cessation guidelines for health professionals: an update.
Thorax, 55 (2000), pp. 987-999
[40]
J la Houezec.
What smoking cessation interventions are effective in preenant women?.
J Gynecol Obstet Biol Reprod (Paris), 34 (2005), pp. S182-S192
[41]
WF Rayburn, MP Bogenschutz.
Pharmacotherapy for pregnant women with addictions.
Am J Obstet Gynecol, 191 (2004), pp. 1885-1897
[42]
T Coleman, J Britton, J Thornton.
Nicotine replacement therapy in pregnancy.
Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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