%0 Journal Article
%T Pregnancy Outcome after Varenicline Exposure in the First Trimester
%A Yusuf Cem Kaplan
%A Nihal Olgac D¨¹ndar
%A Burcu Kasap
%A Bar£¿s Karadas
%J Case Reports in Obstetrics and Gynecology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/263981
%X To the best of our knowledge this is the first case report describing exposure to varenicline, an nicotinic acetylcholine partial receptor agonist used for smoking cessation therapy in pregnancy. A 29-year-old multiparous woman with an unplanned pregnancy has used varenicline 2£¿mg/day unintentionally yet regularly 4 weeks from her last menstrual period. Fetal ultrasound performed at each trimester, detailed anomaly scan, and fetal echocardiography which were performed at the 22nd gestational week showed normal fetal growth with no malformations. The patient delivered a healthy baby at the 38th week of gestation with normal Apgar score and physical examination findings. Age-appropriate physical and neurological development of the child has been observed for 6 months. Although it is not possible to draw definitive conclusions, this case report may contribute to the current available limited data regarding the safety of varenicline use in pregnancy. 1. Introduction Cigarette smoking during pregnancy is associated with a range of adverse pregnancy outcomes such as spontaneous abortion, placental abruption and previa, preterm birth, small for gestational age, and fetal and neonatal death [1, 2]. Although it is ideal to stop smoking before the pregnancy, quitting smoking even during pregnancy, particularly by the 16th week, is reported to have beneficial effects on birth weight and cognitive functions in children [1]. Nicotine replacement therapy (NRT), bupropion, and partial nicotine receptor agonists such as varenicline are pharmacological treatment options for smoking cessation in the general population [3]. Human pregnancy outcome data regarding the use of NRT and bupropion are available to some extent; however data regarding the use of varenicline during pregnancy is only limited to preclinical animal studies. To our knowledge this case report is the first human pregnancy outcome data regarding varenicline exposure in the first trimester of pregnancy. 2. Case Report A 29-year-old multiparous caucasian woman with an unplanned pregnancy has been exposed to varenicline 1£¿mg twice a day unintentionally 4 weeks from her last menstrual period (LMP). Limited rodent data regarding varenicline did not permit a definitive risk assessment; however, after the risk communication with the patient, she decided to continue pregnancy with perinatology follow-up. She received folic acid supplementation between weeks 4 and 12. Fetal ultrasound (USG) performed at each trimester showed normal fetal growth with no malformations. A detailed anomaly scan and fetal
%U http://www.hindawi.com/journals/criog/2014/263981/