妊婦のニコチン代替療法に関する論文がNEJMに載りました。

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2012年03月01日(Thu) 20:05 by drharasho

Nicotine Replacement for Smoking Cessation during Pregnancy
http://www.nejm.org/doi/full/10.1056/NEJMe1200136

Cheryl Oncken, M.D.

N Engl J Med 2012; 366:846-847March 1, 2012

Cigarette smoking during pregnancy increases the risk of delivering
a low-birth-weight or preterm infant, as well as the risks of
pregnancy complications (premature rupture of membranes and
placental abruption) and perinatal and infant death.1 Despite
these risks, 10 to 12% of pregnant women in the United States2
and 6 to 22% of pregnant women in high-income countries3 smoke,
making cigarette smoking a major modifiable cause of adverse
pregnancy outcomes in high-income countries.

Behavioral counseling is recommended for pregnant smokers,
increasing quit rates in this population by 6% to 10% over
usual care4,5; other than counseling, however, it is not clear
how best to treat pregnant smokers. Nicotine-replacement
therapy increases quit rates among nonpregnant smokers,5
but its efficacy during pregnancy is uncertain.

In this issue of the Journal, Coleman and colleagues report
the results of a controlled trial of nicotine-replacement
patches in pregnant women.6 Pregnant smokers were randomly
assigned to receive behavioral counseling and either a standard
course of nicotine patches (at a dose of 15 mg per 16 hours)
or a visually identical placebo. The study treatment was
administered for 4 weeks, followed by an additional 4 weeks
of treatment that was contingent on biochemical evidence of
abstinence from smoking. Although the quit rates at 1 month
were higher in the nicotine-replacement group than in the placebo
group, prolonged quit rates (to the end of pregnancy) were
similar in the nicotine-replacement and placebo groups (9.4%
and 7.6%, respectively). However, overall adherence to therapy
was low; only 7.2% of women in the nicotine-replacement group
and 2.8% of those in the placebo group used the treatment
for more than 4 weeks.

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