Varenicline could be a better option than nicotine replacement therapy (NRT) for pregnant women who want to quit smoking, as it is associated with a reduced risk of preterm birth and other poor outcomes, Australian researchers say.

Their conclusion is based on an eight-year population-based cohort study of 98,000 pregnant smokers in NSW and WA,  including 1057 who used varenicline, 330 who used NRT and 233 who used bupropion.

The NHMRC-funded Smoking MUMS Study found that women using varenicline were 71% less likely than those using NRT to have a preterm birth.

In addition, 2.9% of babies who had been exposed in utero to varenicline in the first trimester had a major congenital anomaly compared with 3.5% not exposed to any smoking cessation therapy.