OBJECTIVE: To compare nicotine concentrations and fetal middle cerebral artery resistance indices (RIs) during 21-mg transdermal nicotine use with these values during maternal smoking. METHODS: In this randomized, crossover study, participants smoked approximately 20 cigarettes daily and were between 24 and 36 weeks' gestation. Subjects were randomized to transdermal nicotine or to smoking ad libitum for 8 hours. One week later, they crossed over to the other condition. Maternal plasma nicotine concentrations and hemodynamic measurements were obtained before and after the onset of smoking or patch placement. RESULTS: Area under the plasma nicotine concentration-time curve during patch use was similar to continued smoking (93 versus 89 ng-hour/mL, respectively) (P = .77). The mean (standard error [SE] change in the middle cerebral artery RI from baseline to 4 hours later was similar during patch use and smoking: -.002 (0.008) versus -.02 (0.015), respectively (P = .3). The study had greater than 80% power to detect a 25% difference in nicotine concentrations and a change of 2 standard deviations in the middle cerebral artery RI between conditions. An unexpected finding was that of a loss of fetal heart rate (FHR) reactivity in 5/8 tracings after patch placement versus 1/6 tracings after smoking (P = .12). The baseline FHR increased by a mean (SE) of 8 (4) beats per minute with loss of reactivity in the patch condition, compared with a decrease of 3 (3) beats per minute without loss of reactivity (P = .05). CONCLUSION: Eight-hour use of 21-mg transdermal nicotine yields nicotine concentrations and middle cerebral artery RIs similar to those produced by hourly smoking in pregnant smokers.
RCT Entities:
OBJECTIVE: To compare nicotine concentrations and fetal middle cerebral artery resistance indices (RIs) during 21-mg transdermal nicotine use with these values during maternal smoking. METHODS: In this randomized, crossover study, participants smoked approximately 20 cigarettes daily and were between 24 and 36 weeks' gestation. Subjects were randomized to transdermal nicotine or to smoking ad libitum for 8 hours. One week later, they crossed over to the other condition. Maternal plasma nicotine concentrations and hemodynamic measurements were obtained before and after the onset of smoking or patch placement. RESULTS: Area under the plasma nicotine concentration-time curve during patch use was similar to continued smoking (93 versus 89 ng-hour/mL, respectively) (P = .77). The mean (standard error [SE] change in the middle cerebral artery RI from baseline to 4 hours later was similar during patch use and smoking: -.002 (0.008) versus -.02 (0.015), respectively (P = .3). The study had greater than 80% power to detect a 25% difference in nicotine concentrations and a change of 2 standard deviations in the middle cerebral artery RI between conditions. An unexpected finding was that of a loss of fetal heart rate (FHR) reactivity in 5/8 tracings after patch placement versus 1/6 tracings after smoking (P = .12). The baseline FHR increased by a mean (SE) of 8 (4) beats per minute with loss of reactivity in the patch condition, compared with a decrease of 3 (3) beats per minute without loss of reactivity (P = .05). CONCLUSION: Eight-hour use of 21-mg transdermal nicotine yields nicotine concentrations and middle cerebral artery RIs similar to those produced by hourly smoking in pregnant smokers.
Authors: N L Benowitz; D A Dempsey; R L Goldenberg; J R Hughes; P Dolan-Mullen; P L Ogburn; C Oncken; C T Orleans; T A Slotkin; H P Whiteside; S Yaffe Journal: Tob Control Date: 2000 Impact factor: 7.552
Authors: Laura J Fish; Bercedis L Peterson; Rebecca J Namenek Brouwer; Pauline Lyna; Cheryl A Oncken; Geeta K Swamy; Evan R Myers; Pamela K Pletsch; Kathryn I Pollak Journal: Nicotine Tob Res Date: 2009-04-07 Impact factor: 4.244
Authors: Geeta K Swamy; Jennifer J Roelands; Bercedis L Peterson; Laura J Fish; Cheryl A Oncken; Pamela K Pletsch; Evan R Myers; Paul W Whitecar; Kathryn I Pollak Journal: Am J Obstet Gynecol Date: 2009-08-07 Impact factor: 8.661
Authors: Kathryn I Pollak; Cheryl A Oncken; Isaac M Lipkus; Pauline Lyna; Geeta K Swamy; Pamela K Pletsch; Bercedis L Peterson; R Phillips Heine; Rebecca J Namenek Brouwer; Laura Fish; Evan R Myers Journal: Am J Prev Med Date: 2007-10 Impact factor: 5.043