Abstract

• Any drug taken during pregnancy exposes the mother and her unborn child to a risk of adverse effects.
   
• When medication is considered during pregnancy, the drug with the best harm-benefit balance for both the mother and the unborn child should be chosen.
   
• If nicotine replacement therapy is effective in helping a pregnant woman to stop smoking, it is probably better for the unborn child than continued smoking.
   
• When a pregnant woman needs help to stop heavy smoking, nicotine replacement therapy is a reasonable choice. In case of nicotine exposure close to delivery, the obstetric team should be informed so that they can monitor and manage the newborn accordingly.
   
• There is no guarantee regarding the composition of electronic cigarettes or the adverse effects of the substances they contain. Long-term follow-up data are also lacking. It therefore seems best to advise pregnant women not to use them.
   
• There is no evidence that electronic cigarettes are less harmful for the unborn child than traditional cigarettes. Similarly, there is no evidence of any particular harm to the unborn child if a mother uses electronic cigarettes during early pregnancy, but there is no guarantee of safety either.
   

©Prescrire 1 June 2015

"Smoking cessation during pregnancy" Prescrire Int 2015; 24 (161): 157-159. (Pdf, subscribers only)