Nicotine replacement therapy is safer than smoking and Australian doctors should feel confident about prescribing it for pregnant women, according to a group of public health physicians and researchers.
A narrative review published in the Medical Journal of Australia, led by Dr Yael Bar-Zeev of the University of Newcastle, suggests many clinicians are not prescribing NRT due to "safety concerns".
This is despite guidelines recommending its use for pregnant women unable to quit smoking unassisted, they say.
"A recent survey of Australian general practitioners and obstetricians, 25 per cent of participants stated that they never prescribe NRT during pregnancy," the authors wrote.
In animal studies nicotine has been shown to cause damage to the lungs and central nervous systems of the fetus.
However, human studies "did not find any harmful effects on fetal and pregnancy outcomes", Dr Bar-Zeeve and colleagues wrote.
The evidence is limited, though, due to small numbers of participants in the meta-analysis.
"Nicotine may not be completely safe for the pregnant mother and fetus but it is always safer than smoking," they concluded.
Quit Victoria director Dr Sarah White says as a first step pregnant women should try behavioural interventions to help them quit smoking.
"But if that's not working for them, pregnant women should not be concerned about using nicotine replacement products as well," she said.
"While nicotine replacement products do contain nicotine, unlike cigarettes they don't contain thousands of cancer-causing toxic chemicals like tar and carbon monoxide so they're nowhere near as harmful as smoking for the woman or unborn child."