Cigarette smoking is one of the most dangerous activities encountered during pregnancy.
It is also the largest preventable cause of death and illness among American women in general. It is estimated
that over 22 million women in this country smoke, and among women of reproductive age (those between the ages of
15-45), almost one-third are smokers.
Over 2,500 chemicals have been identified in cigarette smoke. Most likely, the majority of the adverse effects
are attributable to two main ingredients; nicotine and carbon monoxide. During pregnancy, these chemicals decrease
the oxygen available to the growing fetus, and increase fetal blood pressure. This leads to several potential problems
during pregnancy including increased risk of miscarriage, birth defects, premature delivery, low birth weight,
and fetal death. These problems are dose- dependent which means that the more a pregnant woman smokes, the more
problems her baby will have.
Mothers who breast feed should be aware that nicotine can reach very high levels in breast milk. Breast-fed infants
of smoking mothers do not develop as well as breast-fed infants of non-smoking mothers. In addition, these babies
are at twice the risk of death from sudden infant death syndrome (SIDS).
The good news is that if the pregnant mother can quit smoking before the 16th week of pregnancy (the 4th month),
many of these potential problems disappear. In fact, most women who smoke will quit when they find out they are
pregnant, however, up to 45% do not and continue to put themselves, and their pregnancies at risk.
Nicotine is extremely addictive, similar to the addictive potential of cocaine, but with proper motivation and
guidance many people can quit. The backbone of an effective cessation program involves frequent visits with counselors
and strong family support. Medications such as nicotine gum or patches are generally not recommended during pregnancy
unless prior attempts to quit smoking without medications have failed.
When these medications are used, it should only be under the close supervision of your physician.
