Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian Univeristy of Athens, Hippokration Hospital, Athens, Greece.
Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian Univeristy of Athens, Hippokration Hospital, Athens, Greece.
Hellenic J Cardiol. 2019 Jan-Feb;60(1):11-15. doi: 10.1016/j.hjc.2018.09.001. Epub 2018 Oct 5.
Smoking during pregnancy is a risk factor associated with adverse pregnancy outcomes. Despite the fact that these outcomes are well known, a considerable proportion of pregnant women continue to smoke during this critical period. This paper evaluates critically smoking cessation interventions targeting pregnant women. We describe the findings of key published studies, review papers and expert statements to report the efficacy and safety of strategies for smoking cessation in pregnancy, including counselling and pharmacotherapy. Counselling appears to improve quit rates but mainly when used in combination with pharmacological therapy. Pharmacotherapy is recommended for women who are heavy smokers and are unable to quit smoking on their own. Nicotine replacement therapy is a reasonable first-line drug option. It is recommended that women who are pregnant, or planning to become pregnant, should be informed of potential risks for the foetus before considering smoking cessation therapy with bupropion or varenicline. Pregnant women view electronic nicotine delivery systems as being safer than combustible cigarettes, and this indeed may be the case; however, further evidence is required to assess their effectiveness as a smoking cessation aid and their safety for the mother and the child. Postpartum relapse is a significant problem, with approximately one out of two quitters relapsing in the first 2 months after delivery. These women should be considered 'at risk' and provided with ongoing support.
怀孕期间吸烟是与不良妊娠结局相关的危险因素。尽管这些后果众所周知，但相当一部分孕妇在这一关键时期仍继续吸烟。本文批判性地评估了针对孕妇的戒烟干预措施。我们描述了关键的已发表研究、综述论文和专家声明的结果，以报告妊娠期间戒烟策略的疗效和安全性，包括咨询和药物治疗。咨询似乎可以提高戒烟率，但主要是在与药物治疗联合使用时。对于无法自行戒烟的重度吸烟者，建议使用药物治疗。建议告知计划怀孕或已经怀孕的妇女，在考虑使用安非他酮或伐伦克林进行戒烟治疗之前，应了解吸烟对胎儿的潜在风险。孕妇认为电子烟比可燃香烟更安全，事实可能确实如此；然而，需要进一步的证据来评估它们作为戒烟辅助工具的有效性及其对母亲和孩子的安全性。产后复发是一个严重的问题，大约有一半的戒烟者在分娩后 2 个月内复发。这些女性应被视为“高危”人群，并提供持续的支持。
