Loukopoulou Andriani N, Vardavas Constantine I, Farmakides George, Rosolymos Christos, Chrelias Charalambos, Tzatzarakis Manolis, Tsatsakis Aristeidis, Myridakis Antonis, Lyberi Maria, Behrakis Panagiotis K
General Oncology Hospital of Kifissia 'Agioi Anargyroi', Athens, Greece.
George D. Behrakis Research Lab, Hellenic Cancer Society, Athens, Greece.
Eur J Midwifery. 2018 Nov 14;2:14. doi: 10.18332/ejm/99546. eCollection 2018.
Smoking cessation during pregnancy is beneficial to both the mother and child. Our objective was to assess if an intensive smoking cessation intervention for pregnant women increases: a) rates of smoking cessation, and b) reduces exposure to tobacco-specific carcinogens during pregnancy.
A two-group single-blinded parallel randomized controlled trial (RCT) was conducted involving 84 pregnant smokers in either a high intensity (n=42) or minimal contact control group (n=42). Women assigned to the high intensity smoking cessation intervention group received a single 30-minute behavioural counselling session and a tailored self-help booklet. The primary outcome measures were: 7-day point prevalence abstinence measured by selfreport and urine cotinine levels, and maternal tobacco specific carcinogens nitrosamine (NNAL) urine concentrations assessed at 32 weeks of gestation.
A significantly greater percentage of pregnant smokers quit smoking in the high intensity group compared to the low intensity control group (45.2% vs 21.4%; p=0.001). A significant decrease in urine cotinine concentrations was documented in the experimental group (-140.74 ± 361.70 ng/mL; p=0.004), with no significant decrease documented in the control group. A significant decrease in NNAL levels was also documented in the experimental group (158.17 ± 145.03 pg/mL before, 86.43 ± 112.54 pg/mL after; p=0.032) with no significant changes in the control group.
The high intensity intervention tested resulted in significantly greater cessation rates. Intensive smoking cessation interventions can be effective in reducing fetal exposure to NNAL. This is the first trial to report on NNAL tobacco-specific carcinogen concentrations before and after an intervention for smoking cessation during pregnancy.
ClinicalTrials.gov Identifier: NCT01210118.
5Αs: ask, advise, asses, assist, arrange; GHQ: general health questionnaire; ANOVA: analysis of variance; RCT: randomized control trials; NNAL: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol.
孕期戒烟对母亲和孩子都有益。我们的目标是评估针对孕妇的强化戒烟干预措施是否能提高：a）戒烟率，以及b）减少孕期接触烟草特异性致癌物的情况。
进行了一项两组单盲平行随机对照试验（RCT），涉及84名怀孕吸烟者，分为高强度组（n = 42）或最低接触对照组（n = 42）。分配到高强度戒烟干预组的女性接受了一次30分钟的行为咨询，并收到一本量身定制的自助手册。主要结局指标为：通过自我报告和尿可替宁水平测量的7天点患病率戒烟情况，以及在妊娠32周时评估的母体烟草特异性致癌物亚硝胺（NNAL）尿浓度。
与低强度对照组相比，高强度组中怀孕吸烟者戒烟的比例显著更高（45.2%对21.4%；p = 0.001）。实验组尿可替宁浓度显著下降（-140.74±361.70 ng/mL；p = 0.004），而对照组未出现显著下降。实验组的NNAL水平也显著下降（干预前为158.17±145.03 pg/mL，干预后为86.43±112.54 pg/mL；p = 0.032），对照组无显著变化。
所测试的高强度干预措施导致戒烟率显著提高。强化戒烟干预措施可有效减少胎儿接触NNAL。这是第一项报告孕期戒烟干预前后NNAL烟草特异性致癌物浓度的试验。
ClinicalTrials.gov标识符：NCT01210118。
5Αs：询问、建议、评估、协助、安排；GHQ：一般健康问卷；ANOVA：方差分析；RCT：随机对照试验；NNAL：4-（甲基亚硝胺基）-1-（3-吡啶基）-1-丁醇
