Although the risks of smoking during pregnancy are well known, the mechanisms of these effects, and the specific role that nicotine plays in their development is not well understood. The present study will examine the effects of smoking or nicotine on measures of fetal hypoxemia (fetal breathing movements and heart rate variability) and maternal sympathetic activation (urinary epinephrine and norepinephrine concentrations). Furthermore, it will assess whether altering the mode of nicotine delivery (fast, intermittent, nicotine nasal spray versus slow continuous release transdermal nicotine) has differing effects on measures of fetal hypoxemia and maternal sympathetic activation. This information, combined with assessment of maternal tolerability and preferences, will determine which nicotine delivery system may be optimal for smoking cessation during pregnancy.
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