Smoking in pregnancy: pathophysiology of harm and current evidence for monitoring and cessation 2019 TOG

Question 1

Risk of smoking in pregnancy

Answer 1

Miscarriage
Stillbirth
Placental abruption
Preterm birth
Low birth weight
Longtime neonatal outocme - sudden infant death, ADAD, poor academic performance

Question 2

Prevalence smoking UK?

Answer 2

12.9%

Question 3

Whilst smoking 1 cigarette how much carbon monoxide exposed to?

Answer 3

400-500ppm producing 4% carboxyhaemoglobin vs 1% of non smokers

Heavy smokers up to 15

Question 4

WHho should be referred to NHS stop smoking

Answer 4

Current, occasional and smokers who have quit in last 2 weeks.
CO > 4ppm

Question 5

Impact of CO on fetus

Answer 5

Chronic expose - FGR and preterm birth

Question 6

Impact of Tar on fetus

Answer 6

FGR ?teratogenic
Accumulates in placenta

Question 7

Effect nicotine on fetus

Answer 7

Cognitive, emotional and behaviour disorder, learning disability, addictive behaviours (including smoking)

Question 8

What proportion of smokers stop in 1st trimester?

Answer 8

27-47%

High relapse in PM period

Question 9

How much does NRT increase cessation rate?

Answer 9

50-60%

Question 10

Electronic smokers have reduced theoretical harm to baby’s cigarettes smokers

Answer 10

95% vs

Question 11

What proportion of adult population use e Cig?

Answer 11

5.5%
0.2% never smokers

Limited evidence on safety in pregnancy