Is the apparently protective effect of maternal nicotine replacement therapy (NRT) used in pregnancy on infant development explained by smoking cessation?: secondary analyses of a randomised controlled trial.
Adult
Child Development
England
Female
Humans
Infant
Infant, Newborn
Logistic Models
Nicotine
/ administration & dosage
Outcome Assessment, Health Care
Pregnancy
Pregnancy Complications
/ prevention & control
Pregnancy Outcome
Smoking
/ adverse effects
Smoking Cessation
Smoking Prevention
Time
Tobacco Use Cessation Devices
Young Adult
child development
developmental impairment
maternal smoking
smoking in pregnancy
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
11 07 2019
11 07 2019
Historique:
entrez:
14
7
2019
pubmed:
14
7
2019
medline:
24
7
2020
Statut:
epublish
Résumé
To investigate relationships between maternal smoking status in pregnancy and infant development. The largest randomised controlled trial of nicotine replacement therapy (NRT) for smoking cessation in pregnancy, the smoking, nicotine and pregnancy (SNAP) trial, found that at 1 month after randomisation, smoking cessation rates were doubled in the NRT group compared with the placebo group. At delivery, there was no significant difference in cessation rates between groups. Surprisingly, infants born to women randomised to NRT were more likely to have unimpaired development at 2 years. We hypothesised that this apparently protective effect was due to smoking cessation caused by NRT and so, investigate this relationship using the same cohort. Secondary analysis of a randomised controlled trial. Seven antenatal hospitals in the Midlands and North-West England. Eight hundred and eighty-four pregnant smokers randomised to receive either NRT patches or visually-identical placebo in the SNAP trial. Participants' smoking behaviour were recorded at randomisation, 1 month after their target quit date and at delivery. Using logistic regression models, we investigated associations between participants' smoking measures and infant development (assessed using the Ages and Stages questionnaire) at 2 years. 2 year infant development. Developmental impairment was reported for 12.7% of study 2 year olds. Maternal heaviness of smoking at randomisation (OR: 1.26, 95% CI: 0.82 to 1.96, p=0.091), validated smoking abstinence recorded at 1 month after a quit date (OR: 1.02, 95% CI: 0.60 to 1.74, p=0.914) and validated smoking abstinence recorded at both 1 month after a quit date and at the end of pregnancy (OR: 1.52, 95% CI: 0.81 to 2.85, p=0.795) were not independently associated with infant developmental impairment at 2 years. We found no evidence that NRT treatment improved infants' developmental outcomes through smoking cessation. CTA03057/0002/001-0001; Post-results.
Identifiants
pubmed: 31300493
pii: bmjopen-2018-024923
doi: 10.1136/bmjopen-2018-024923
pmc: PMC6629395
doi:
Substances chimiques
Nicotine
6M3C89ZY6R
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e024923Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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