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Related Experiment Video

Updated: Jun 7, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

Nicotine replacement therapy effect on pregnancy outcomes.

Alicia B Forinash¹, Jamie M Pitlick, Kylie Clark

¹Department of Pharmacy Practice, St. Louis College of Pharmacy, MO, USA. aforinash@stlcop.edu

The Annals of Pharmacotherapy

|October 28, 2010

Summary

Nicotine replacement therapy (NRT) in pregnancy is recommended if behavior modification fails, as it reduces risks of preterm delivery and low birth weight compared to continued smoking. NRT does not appear to increase malformation risks.

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Area of Science:

Obstetrics and Gynecology
Pharmacology
Public Health

Background:

Smoking during pregnancy poses significant risks to both maternal and fetal health.
Behavior modification is the primary recommended treatment for smoking cessation in pregnant individuals.
Nicotine replacement therapy (NRT) is a potential alternative when behavioral interventions are insufficient.

Purpose of the Study:

To review existing data on the effects of nicotine replacement therapy (NRT) during pregnancy.
To assess the impact of NRT on fetal, neonatal, and maternal outcomes.
To evaluate the safety and efficacy of NRT for smoking cessation in pregnant populations.

Main Methods:

A comprehensive literature search was conducted using PubMed and the Cochrane Database.
Studies published in English, including human subjects, were evaluated.
Data on pregnancy outcomes and malformation rates associated with NRT use were analyzed.

Main Results:

NRT use was associated with a significant decrease in the risk of preterm delivery and low birth weight compared to continued smoking.
One study indicated a potential increased risk for any fetal malformation with NRT, but without adjustments for confounding factors.
No increased risk for major or musculoskeletal malformations was observed.

Conclusions:

Behavior modification therapy is the first-line approach for smoking cessation in pregnancy.
NRT should be considered when behavioral therapies are unsuccessful, offering benefits over continued smoking.
Current evidence suggests NRT does not significantly increase the risk of malformations in pregnancy.