- Smoking may impair fertility. It can damage ovaries and possibly the uterus.
- Tobacco use during pregnancy increases risk of preterm birth, small for gestational age babies
and risk for having a baby with a heart defect.
- Provide smoking cessation support. Behavioral therapy is first line.
- Nicotine replacement therapy is preferred over continued smoking.
- IUD or sub-dermal contraception is preferred.
- Avoid estrogen if over 35 years of age, obese, or other vascular risk factors present.
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