Alys Havard of the University of New South Wales and colleagues from five countries conducted a retrospective cohort study and concluded that taking essential smoking cessation medications in the first trimester of pregnancy does not increase the risk of major birth defects in the child. The analysis included all 5.2 million births that occurred from the beginning of 2001 to the end of 2020 in New South Wales, New Zealand, Norway, and Sweden. Nine thousand three hundred and twenty-five newborns, all of whom were smokers before pregnancy, received nicotine replacement therapy in the first trimester, 3,031 received varenicline, and 1,042 received bupropion. The results of the study were published in JAMA Internal Medicine.
The study found no significant association between the use of either medication and the overall risk of major congenital anomalies. Analysis of individual body systems revealed only a slightly increased risk of gastrointestinal defects with nicotine replacement therapy and urinary tract defects with varenicline. Given the harm caused by smoking, these results provide strong support for the advisability and safety of such medications during the first trimester of pregnancy.
