[Smoking, the pill and pregnancy]

The intake of modern low-dose oral contraceptives (estrogen dose less than 50 micrograms, gestagen without androgen function) does not augment the danger for cardiovascular disease, especially if individual risk factors are missing. These include besides age, hypertension, obesity and disturbances of lipid and carbohydrate metabolism especially smoking. Women older than 35 years of age who smoke (more than 15 cigarettes per day) should strongly be advised to use other contraceptive means. There are numerous disturbances that may occur in utero and post partum in the child if the pregnant woman or mother smokes actively. Most obvious are intrauterine retardation of fetal growth, neurological and psychic disorders, pulmonary problems and an increased risk for cancer in small children. Since there is also danger for unborn and small children in passive smoking, we must become more aware of the problem and take measures accordingly.