期刊
OBSTETRICS AND GYNECOLOGY
卷 112, 期 4, 页码 859-867出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/AOG.0b013e318187e1ec
关键词
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资金
- NCRR NIH HHS [M01 RR006192-110258, M01 RR006192-120258, M01 RR006192-137329, M01 RR006192] Funding Source: Medline
- NIAAA NIH HHS [K24 AA013736-03, K24 AA013736-04, K24 AA013736-05, K24 AA013736-02, K24 AA013736-06, P50 AA015632-10, K24 AA013736-01, K24 AA013736, K24 AA13736, P50 AA015632] Funding Source: Medline
- NIDA NIH HHS [R01 DA15167, R01 DA015167-03, R01 DA015167, R01 DA015167-01, R01 DA015167-04, R01 DA015167-05, P50 DA013334, R01 DA015167-02, P50 DA013334-01] Funding Source: Medline
OBJECTIVE: To estimate the safety and efficacy of treatment with 2-mg nicotine gum for smoking cessation during pregnancy. METHODS: Pregnant women who smoked daily received individualized behavioral counseling and random assignment to a 6-week treatment with 2-mg nicotine gum or placebo followed by a 6-week taper period. Women who did not quit smoking were instructed to reduce the number of cigarettes smoked by substituting with gum. Measures of tobacco exposure were obtained throughout the study. RESULTS: Participants in the nicotine (n=100) and placebo (n=94) groups were comparable in age, race/ethnicity, and smoking history. Biochemically validated smoking-cessation rates were not significantly higher with nicotine gum compared with placebo (after 6 weeks of treatment: 13% compared with 9.6%, P=.45; at 32-34 weeks of gestation: 18% compared with 14.9%, P=.56). Using a completer analysis, nicotine gum significantly reduced the number of cigarettes smoked per day (nicotine gum: -5.7 [standard deviation (SD)=6.0]; placebo: -3.5 [SD=5.7], P=.035), and cotinine concentration (nicotine gum: -249 ng/mL [SD=397]; placebo: -112 ng/mL [SD=333]; P=.04). Birth weights were significantly greater with nicotine gum compared with placebo (3,287 g [SD=566] and 2,950 g [SD=653], respectively, P<.001). Gestational age was also greater with nicotine-replacement therapy than with placebo (38.9 weeks [SD=1.7] and 38.0 weeks [SD=3.3], respectively; P=.014). CONCLUSION: Although nicotine gum did not increase quit rates, use of nicotine gum increased birth weight and gestational age, two key parameters in predicting neonatal wellbeing.
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