Recent research suggests that the regular use of nicotine patches or e-cigarettes among pregnant mothers is not associated with adverse pregnancy outcomes, according to findings from a secondary analysis of a large randomized controlled trial (RCT). Led by Francesca Pesola, MSc, PhD, from the Wolfson Institute of Population Health at Queen Mary University of London in the UK, the study aimed to evaluate the impact of nicotine patches and e-cigarettes on pregnant smokers.
The ‘PREP’ study involved 1140 pregnant individuals identified as daily smokers seeking assistance in quitting smoking. Participants expressed no preference for either e-cigarettes or nicotine patches and had no current usage of either. Outcomes related to birth and maternal health were assessed in 1095 individuals, excluding those who opted for elective termination, withdrew before delivery, gave birth outside of study sites with missing information, or delivered twins.
Instead of comparing randomized groups, the research team conducted a secondary analysis comparing outcomes in participants who did and did not regularly use these nicotine products during pregnancy. Baseline demographic and smoking history data were examined, with saliva samples collected. Telephone communication occurred during weeks 1–4 post-target quit date and at the end of participants’ pregnancies.
The study explored smoking status and nicotine product use, assessing respiratory symptoms and cotinine analysis to validate self-reported abstinence and smoking habit reduction. Adverse events were monitored during each contact, and birth and maternal outcomes were recorded through hospital data.
Results showed that e-cigarettes were more commonly used than nicotine patches (47.3% vs. 21.6%, P < .001), with a 45% salivary cotinine reduction observed among mothers who quit smoking and used e-cigarettes at the end of pregnancy. Abstainers using either nicotine product had higher birth weights than smokers, and no worse outcomes or increased adverse events were detected among either abstainers or smokers using nicotine products.
The study concluded that the use of e-cigarettes or nicotine patches by smokers attempting to quit did not pose risks to pregnancy. While these findings may alleviate concerns about using nicotine-containing products to help pregnant smokers quit, the researchers emphasized the need for further studies to validate these results.
