[Physiological and Psychological Data influencing Pregnant Women Smoking Behavior - CNGOF-SFT Expert Report and Guidelines for Smoking Management during Pregnancy].

Données physiologiques et psychologiques influençant le comportement tabagique de la femme enceinte – Rapport d’experts et recommandations CNGOF-SFT sur la prise en charge du tabagisme en cours de grossesse.

Journal

Gynecologie, obstetrique, fertilite & senologie
ISSN: 2468-7189
Titre abrégé: Gynecol Obstet Fertil Senol
Pays: France
ID NLM: 101693805

Informations de publication

Date de publication:
Historique:
pubmed: 5 4 2020
medline: 25 11 2021
entrez: 5 4 2020
Statut: ppublish

Résumé

Nicotine is the main addictive substance in tobacco and its addictive effects mainly involve dopamine. Nicotine is mainly metabolized (C-oxidation) in the liver to cotinine by the cytochrome P450 enzyme system. Nicotine half-life is short being about 2hours. Nicotine metabolism appears to be increased during pregnancy, mainly due to an increased cytochrome activity and maternal cardiac output. Thus, the smoking behavior of the pregnant woman is subsequently modified with an increase in withdrawal syndromes and an increased desire to smoke. These pharmacological elements should be taken into account when prescribing nicotine replacement therapy. Regarding the markers of tobacco intoxication, there is a good correlation between the importance of smoking and the measurement of expired air carbon monoxide. Although there is no evidence of decreased obstetrical complications related to its use, it is simple and non-invasive and therefore may be useful in routine practice. It gives an instantaneous value of tobacco intoxication, and represents a starting point for dialogue and management and can help to highlight the reality of withdrawal. Regarding the evaluation of tobacco addiction, the most commonly used questionnaires are the Fagerström tests (FTCD, HSI…), which are well correlated with cotinine concentration. However, there is insufficient evidence of their usefulness in reducing tobacco consumption during pregnancy to recommend them in current practice. DSM-V diagnostic criteria for addiction should be known as they can also be used to characterize the intensity of this addiction.

Identifiants

pubmed: 32247097
pii: S2468-7189(20)30136-7
doi: 10.1016/j.gofs.2020.03.023
pii:
doi:

Substances chimiques

Cotinine K5161X06LL

Types de publication

Practice Guideline Journal Article

Langues

fre

Sous-ensembles de citation

IM

Pagination

551-558

Informations de copyright

Copyright © 2020 Elsevier Masson SAS. All rights reserved.

Auteurs

P Berveiller (P)

Service de gynécologie-obstétrique, CHI de Poissy St-Germain, 78300 Poissy, France. Electronic address: paulberveiller@yahoo.fr.

E Rault (E)

Service d'obstétrique, hospices civils de Lyon, hôpital Femme-Mère-Enfant Lyon, 69500 Bron, France.

P Guerby (P)

Service de gynécologie-obstétrique, CHU de Toulouse, 31300 Toulouse, France.

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Classifications MeSH