Pregnancy And Smoking Cessation

Yıl 2018, Cilt: 15 Sayı: 1, 24 - 27, 01.01.2018

Serkan Kahyaoğlu , Şule Özel Yaprak Engin Üstün Cevdet Erdöl

Öz

Cigarette smoking is an antenatal risk factor causing maternal and fetal morbidity besides being a public health issue. Smoking during pregnancy is associated with increased preterm birth, low birth weight, preterm rupture of the membranes, intrauterine growth retardation, ectopic pregnancy and perinatal mortality rates. Newborns who have been exposed to effects of cigarette smoking are prone to asthma, infantile colic, depression and childhood obesity. Although women who smoke before pregnancy are motivated to quit smoking, they occasionally need professional help to succeed this behaviour. Perinatal outcomes improve by quitting cigarette smoking before pregnancy or as soon as possible during pregnancy. Counseling, cognitive and behavioural therapy, hypnosis, acupuncture and pharmacological agents are treatment choices. Owing to the fact that insufficient evidence about safety and efficacy exist, pharmacological treatment modalities are not recommended during pregnancy.

Anahtar Kelimeler

Pregnancy, smoking cessation

Gebelik Ve Sigara Bırakma

Öz

Sigara kullanımı toplum sağlığı sorunu olmasının yanında maternal ve fetal morbiditeye neden olan bir antenatal risk faktörüdür. Gebelikte sigara içilmesi düşük doğum ağırlığı, preterm doğum, erken membran ruptürü, intrauterin gelişme kısıtlılığı, ektopik gebelik ve perinatal mortalitede artış ile ilişkilidir. Yenidoğanlarda ise sigara dumanına maruziyet astım, infantil kolik, depresyon ve çocukluk obezitesi ile ilişkili bulunmuştur. Gebelik öncesinde sigara kullanan kadınlar gebe kaldıklarında genellikle sigarayı bırakmaya motive olmalarına rağmen bunu başarmak için profesyonel yardıma ihtiyaç duyabilirler. Gebelik öncesinde veya gebelikte mümkün olan en erken gebelik haftasında sigaranın bırakılması ile perinatal sonuçlar iyileşmektedir. Sigarayı bırakmada bilgi verme, kognitif ve davranışsal tedaviler, hipnoz, akupunktur ve farmakolojik tedavi kullanılmaktadır. Farmakolojik tedavilerin güvenilirliği ve etkinliği belli olmadığından sigarayı bırakmak için gebelikte kullanımları önerilmemektedir.

Anahtar Kelimeler

Gebelik, sigara bırakma

Kaynakça

• Tong VT, Jones JR, Dietz PM, D’Angelo D, Bombard JM. Trends in smo- king before, during, and after pregnancy - Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 31 sites, 2000-2005. Cen- ters for Disease Control and Prevention (CDC). MMWR Surveill Summ 2009;58:1–29.
• Türkiye İstatistik Kurumu. Küresel Yetişkin Tütün Araştırması Mikro Veri Seti, ISBN: 978-975-19-5751-1, 2012.
• https://www.saglik.gov.tr/TR,3286/turkiyede-tutun-kontrolu-calismala- ri-31052012.html
• Orton S, Coleman T, Coleman-Haynes T, Ussher M. Predictors of Post- partum Return to Smoking: A Systematic Review. Nicotine Tob Res. 2017 Jul 25. doi: 10.1093/ntr/ntx163. [Epub ahead of print] PubMed PMID: 29065203.
• Winklbaur B, Baewert A, Jagsch R. Association between prenatal tobac- co exposure and outcome of neonates born to opioid-maintained mot- hers. Implications for treatment. Eur Addict Res 2009; 15(3):150–156.
• Dolan CV, et al. Testing Causal Effects of Maternal Smoking During Preg- nancy on offspring’s Externalizing and Internalizing Behavior. Behav Ge- net. 2016;46:378–388. doi: 10.1007/s10519-015-9738-2.
• Adamcova K, Kolatorova L, Chlupacova T, Simkova M, Jandikova H, Parizek A, Starka L, Duskova M. Changes to fetal steroidogenesis cau- sed by maternal smoking. Physiol Res. 2017 Sep 26;66(Supplementum 3):S375-S386.
• McDonald SD, Walker MC, Ohlsson A, Murphy KE, Beyene J, Perkins SL. The effect of tobacco exposure on maternal and fetal thyroid function. Eur J Obstet Gynecol Reprod Biol 2008;140:38–42.
• Castles A, Adams EK, Melvin CL, Kelsch C, Boulton ML. Effects of smoking during pregnancy. Five meta-analyses. Am J Prev Med 1999;16:208–15.
• SpinilloA,NicolaS,PiazziG,GhazalK,ColonnaL,BaltaroF. Epidemiological correlates of preterm premature rupture of membranes. Int J Gynaecol Obstet 1994;47:7–15.
• Delpisheh A, Brabin L, Drummond S, Brabin BJ. Prenatal smoking expo- sure and asymmetric fetal growth restriction. Ann Hum Biol. 2008 Nov- Dec;35(6):573-83. doi: 10.1080/03014460802375596.
• Williams MA, Mittendorf R, Lieberman E, Monson RR, Schoenbaum SC, Genest DR. Cigarette smoking during pregnancy in relation to placenta previa. Am J Obstet Gynecol. 1991 Jul;165(1):28-32.
• England MC, Benjamin A, Abenhaim HA. Increased risk of preterm pre- mature rupture of membranes at early gestational ages among mater- nal cigarette smokers. Am J Perinatol. 2013 Nov;30(10):821-6. doi: 10.1055/s-0032-1333408. Epub 2013 Jan 17.
• Saraiya M, Berg CJ, Kendrick JS, Strauss LT, Atrash HK, Ahn YW. Cigaret- te smoking as a risk factor for ectopic pregnancy. Am J Obstet Gynecol. 1998 Mar;178(3):493-8.
• Ananth CV, Savitz DA, Luther ER. Maternal cigarette smoking as a risk factor for placental abruption, placenta previa, and uterine bleeding in pregnancy. Am J Epidemiol. 1996 Nov 1;144(9):881-9.
• Sawicka-Gutaj N, Gutaj P, Sowiński J, Wender-Ożegowska E, Czarnywo- jtek A, Brązert J, Ruchała M. Influence of cigarette smoking on thyro- id gland-an update. Endokrynol Pol. 2014;65(1):54-62. doi: 10.5603/ EP.2014.0008.
• Weitzman M, Gortmaker S, Walker DK, Sobol A. Maternal smoking and childhood asthma. Pediatrics. 1990 Apr;85(4):505-11.
• Reijneveld SA, Brugman E, Hirasing RA. Infantile colic: maternal smoking as potential risk factor. Arch Dis Child. 2000 Oct;83(4):302-3.
• von Kries R, Toschke AM, Koletzko B, Slikker W Jr. Maternal smoking during pregnancy and childhood obesity. Am J Epidemiol. 2002 Nov 15;156(10):954-61.
• Dietz PM, England LJ, Shapiro-Mendoza CK, Tong VT, Farr SL, Callaghan WM. Infant morbidity and mortality attributable to prenatal smoking in the U.S. Am J Prev Med 2010;39:45 –52.
• Committee on Underserved Women; Committee on Obstetric Prac- tice. Committee Opinion No. 721: Smoking Cessation During Preg- nancy. Obstet Gynecol. 2017 Oct;130(4):e200-e204. doi: 10.1097/ AOG.0000000000002353.
• Modified from Fiore MC, Jaen CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, et al. Treating tobacco use and depen- dence: 2008 update. Clinical Practice Guideline. Rockville (MD): U.S. Department of Health and Human Services, Public Health Service; 2008. Available at: http:// www.surgeongeneral.gov/ tobacco/treating_tobacco_use08.pdf. Retrie- ved July 6, 2010.
• Centers for Disease Control and Prevention. E-cigarettes and pregnan- cy. Atlanta (GA): CDC; 2016. Available at: https://www.cdc.gov/repro- ductivehealth/maternalin- tes-pregnancy. htm. Retrieved June 12, 2017.
• Fiore MC, Jaen CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, et al. Treating tobacco use and dependence: 2008 update U.S. Public Health Service Clinical Practice Guideline executive summary. 2008 PHS Guideline Update Panel, Liaisons, and Staff. Respir Care. 2008 Sep;53(9):1217-22.
• El Dib R, Suzumura EA, Akl EA, Gomaa H, Agarwal A, Chang Y, et al. Electronic nicotine delivery systems and/ or electronic non-nicotine deli- very systems for tobacco smoking cessation or reduction: a systematic review and meta-analysis. BMJ Open 2017;7:e012680.