Peyronnet V, Le Faou A-L, Berlin I
Service de gynécologue-obstétrique, hôpital Louis-Mourier, AP-HP, Colombes, France.
Centre ambulatoire d'addictologie, hôpital européen Georges-Pompidou, centre - université Paris-Cité, AP-HP, Paris, France.
Rev Mal Respir. 2024 Nov;41(9):685-695. doi: 10.1016/j.rmr.2024.06.009. Epub 2024 Aug 28.
Smoking during pregnancy is associated with negative pregnancy and perinatal health outcomes. Physiological and societal particularities can modify the smoking behavior of pregnant women. Pregnancy is a teachable moment for smoking cessation. Increased nicotine clearance may lead to exacerbated tobacco withdrawal symptoms and desire to smoke, which need to be taken into account when helping pregnant smokers to quit. Although most pregnant smokers try to quit on their own, 12% of pregnant women in France reported smoking in 2021 during the 3 trimester of pregnancy. Health care professionals should screen for tobacco consumption and assess the level of addiction. Management of smoking cessation can be multidisciplinary, including non-pharmacological support such as counselling, behavioral support, financial reward contingent on abstinence, and medication (nicotine replacement therapies). Assessment and limitation of secondhand smoke exposure (SHS) is needed because SHS can also have negative maternal and fetal consequences. Management of relapse during the postpartum period is also to be anticipated; in 2021, it concerned 22.4% of women who had stopped smoking during pregnancy. While electronic cigarette use is increasing overall and among pregnant women who smoke (5.4 before pregnancy, 1.3% during the 3rd trimester in 2021), well-conducted smoking cessation studies are necessary to assess its benefits and potential risks in this specific group of smokers.
孕期吸烟与不良妊娠及围产期健康结局相关。生理和社会特殊性可能会改变孕妇的吸烟行为。孕期是戒烟的适当时机。尼古丁清除率增加可能导致烟草戒断症状加剧和吸烟欲望增强，在帮助怀孕吸烟者戒烟时需要考虑到这一点。尽管大多数怀孕吸烟者试图自行戒烟，但2021年法国有12%的孕妇在妊娠晚期仍在吸烟。医疗保健专业人员应筛查烟草消费情况并评估成瘾程度。戒烟管理可以是多学科的，包括非药物支持，如咨询、行为支持、基于戒烟的经济奖励以及药物治疗（尼古丁替代疗法）。需要评估并限制二手烟暴露，因为二手烟也会对母婴产生不良后果。产后复吸的管理也需要提前考虑；2021年，这涉及到22.4%在孕期戒烟的女性。虽然电子烟的使用总体上以及在吸烟的孕妇中都在增加（孕前为5.4%，2021年妊娠晚期为1.3%），但有必要开展严谨的戒烟研究，以评估其在这一特定吸烟群体中的益处和潜在风险。
