Smoking and Its Risks during Your Pregnancy

By Joanne Stone, Keith Eddleman, Mary Duenwald

Unless you’ve been living on Mars for the past ten years, you no doubt are aware that smoking is a health risk for you. When you smoke, you run the risk of developing lung cancer, emphysema, and heart disease, among other illnesses. During pregnancy, however, smoking poses risks to your baby as well.

The carbon monoxide in cigarette smoke decreases the amount of oxygen that your growing baby receives, and nicotine cuts back on blood flow to the fetus. Consequently, women who smoke stand an increased chance of delivering babies with low birth weight, which may mean more medical problems for the baby.

In fact, babies born to smokers are expected to weigh a half-pound less, on average, than those born to nonsmokers. The exact difference in birth weight depends on how much the mother smokes. Secondhand smoke is also a risk.

In addition to low birth weight, smoking during pregnancy is associated with a greater risk of preterm delivery, miscarriage, placenta previa, placental abruption, preterm rupture of the amniotic membranes, and even sudden infant death syndrome (SIDS) after the baby is born.

Quitting smoking can be extremely difficult. But keep in mind that even cutting back on the number of cigarettes you smoke is beneficial to your baby (and yourself).

If you quit smoking during the first three months you’re pregnant, give yourself a pat on the back and be reassured that your baby is likely to be born at a normal weight and have fewer health issues.

Some women use nicotine patches, gum, lozenges, or inhalers to help them kick the habit. The nicotine from these products is still absorbed into the bloodstream and can still reach the fetus, but at least the carbon monoxide and other toxins in cigarette smoke are eliminated.

The American College of Obstetrics and Gynecology recommends that nicotine replacements such as these may be used when non-pharmacologic treatments have failed. The total amount of nicotine absorbed from the intermittent use of the gum or inhalers may be less than the amount from the patch, which is used continuously.

The effects on fetal development with the use of bupropion (Zyban or Wellbutrin) haven’t been extensively studied, but one well-designed study showed that pregnant smokers receiving bupropion were much more likely to quit than those not taking the medication.