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Nicotine Patch and Pregnancy

If a woman smokes during pregnancy, she has an increased risk for miscarriage, preterm delivery, and having a baby with low birth weight. Is it safer for a pregnant woman to use the nicotine patch? Although the patch is generally considered safer than smoking during pregnancy, it is typically recommended for pregnant women to stop smoking on their own without nicotine replacement therapy.

Is It Safe for Women to Use the Nicotine Patch During Pregnancy?

The nicotine patch (Nicoderm® CQ®) is a nonprescription medication used to help people stop smoking. It helps reduce nicotine withdrawal symptoms, including nicotine craving. As a pregnancy Category D medicine, the nicotine patch may be harmful to an unborn child.

What Is Pregnancy Category D?

The U.S. Food and Drug Administration (FDA) uses a category system to classify the possible risks to a fetus when a specific medicine is taken during pregnancy. Pregnancy Category D is a classification given to medicines that have been shown to present a risk to the fetus in studies of pregnant women but may still offer benefits that outweigh the risks the drug presents.
A pregnancy Category D medicine may still be given to a pregnant woman if the healthcare provider believes that the benefits to the woman outweigh the possible risks to her unborn child.
When given to pregnant mice at high doses, nicotine (the active ingredient of the nicotine patch) increased the risk of bone problems in the offspring. In addition, high doses of nicotine caused fetal breathing problems when given to pregnant sheep and monkeys, as well as low blood pressure in the monkey offspring.
The negative consequences of smoking before, during, and after pregnancy are well established. Women who smoke while pregnant have a greater risk for miscarriage, preterm delivery, and having a baby with low birth weight. Smoking after giving birth has been associated with sudden infant death syndrome (SIDS).
The nicotine patch has not been studied in pregnant women; however, using the nicotine patch is considered safer than smoking during pregnancy. It is generally recommended that women first try to quit smoking without using a nicotine replacement medicine. Realistically, this may be very difficult to do. If you are finding it hard to quit smoking during pregnancy, your healthcare provider may recommend a medication like the nicotine patch to help you stop.
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