Pregnancy Journal (Deluxe, Cloth-bound edition): A Week-By-Week Guide to a Happy, Healthy Pregnancy

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The review included 64 studies analysing the relationship between maternal SDP and 46 health conditions. The highest increase in risks was found for sudden infant death syndrome, asthma, stillbirth, low birth weight and obesity amongst infants. The impact of SDP was associated with the number of cigarettes consumed. According to the causal link analysis, five mother-related and ten infant-related conditions had a causal link with SDP. In addition, some studies reported protective impacts of SDP on pre-eclampsia, hyperemesis gravidarum and skin defects on infants. The review identified important gaps in the literature regarding the dose-response association, exposure window, postnatal smoking. Conclusions Bath SC, Steer CD, Golding J, Emmett P, Rayman MP. Effect of inadequate iodine status in UK pregnant women on cognitive outcomes in their children: results from the Avon Longitudinal Study of Parents and Children (ALSPAC). Lancet. 2013 Jul 27;382(9889):331–7.

Methadone or buprenorphine (as per standard protocols) is prescribed at a dose that stops or minimises illicit opioid use, with a focus on maintaining stability. 7 Methadone dosing may need to be increased in the third trimester of pregnancy as its metabolism increases. 20 Consider split dosing to minimise fetal intoxication or withdrawal. 47 The choice of buprenorphine versus methadone should be individualised to the patient, and switching during pregnancy, particularly if use is well maintained, is discouraged. 7 Assess types and amounts of substances—“What are you taking? How do you use it and how often? Are you using anything else? How much are you spending?” Zhang D, Cui H, Zhang L, Huang Y, Zhu J, Li X. Is maternal smoking during pregnancy associated with an increased risk of congenital heart defects among offspring? A systematic review and meta-analysis of observational studies. J Matern-Fetal Neonatal Med. 2017;30(6):645–57. https://doi.org/10.1080/14767058.2016.1183640. Montgomery SM, Ekbom A. Smoking during pregnancy and diabetes mellitus in a British longitudinal birth cohort. Br Med J. 2002;324(7328):26–7. https://doi.org/10.1136/bmj.324.7328.26. This may be followed with discussion about perceived barriers to stopping or reducing substance useXuan Z, Zhongpeng Y, Yanjun G, Jiaqi D, Yuchi Z, Bing S, et al. Maternal active smoking and risk of oral clefts: a meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122(6):680–90. https://doi.org/10.1016/j.oooo.2016.08.007. Try to find the right day, time, and place for a time of peaceful reflection or meditation. Take a deep breath, exhale and consider what has happened and how you feel before you start putting pen to paper. Physiological withdrawal state when substance use is stopped or reduced (symptoms vary depending on the substance); may also be associated with use of the substance (or a closely related one) to relieve or avoid the withdrawal symptoms CARE Study Group. Maternal caffeine intake during pregnancy and risk of fetal growth restriction. A Large prospective observational study. British Medical Journal 2008 337: a2332

Royal College of Obstetricians & Gynaecologists. The management of nausea and vomiting of pregnancy and hyperemesis gravidarum. RCOG Green-top Guideline No. 69. Jun 2016. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/green-top-guidelines/gtg69-hyperemesis.pdfTo define light, moderate and heavy smokers, most studies [ 38, 39, 46, 62, 63, 64] chose smoking 10 cigarettes daily as a cut-off point to distinguish light smokers from moderate and heavy smokers. In some studies [ 4, 39, 46, 61, 64], both 10 cigarettes daily and 20 cigarettes daily were utilised as the thresholds. In one review the number of cigarettes consumed daily for each category was inconsistent [ 65]. All studies estimated the risk ratios compared to non-smokers [ 66], except for one review, in which light smokers were compared to moderate smokers. Salihu HM, Wilson RE. Epidemiology of prenatal smoking and perinatal outcomes. Early Hum Dev. 2007;83(11):713–20. https://doi.org/10.1016/j.earlhumdev.2007.08.002.