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A systematic review and meta-analysis of prospective studies on the association between maternal cigarette smoking and preterm delivery
Open accessAbstract
We have attempted to quantify the most up-to-date estimate of the association between cigarette smoking by the mother and preterm delivery. Studies were selected for inclusion in this review if they were prospective, reported data stratified across at least two levels of maternal smoking, and defined preterm delivery on the basis of gestational age. In a meta-analysis we combined results from multiple studies that reported on preterm delivery and maternal smoking during pregnancy. Pooled odds ratios were computed for various strata of smoking intensity with the Mantel-Haenszel fixed-effects model. Twenty studies met all inclusion criteria and were included in meta-analysis. The pooled point estimate from 20 prospective studies on any maternal smoking versus no maternal smoking was 1.27 (95% confidence interval, 1.21-1.33). Subgroup analyses stratifying maternal smoking on number of cigarettes per day suggest a dose-response relationship at low to moderate levels of smoking, which was not further increased at high levels of smoking. A nonsignificant level of publication bias appears to exist in the smoking-preterm delivery literature. Cigarette smoking is a preventable risk factor that is associated with preterm delivery. Consistent results across many study populations and research designs and evidence of a dose-response relationship support its causal role in preterm delivery.
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“In accordance with previous studies, we indeed found that smoking is associated with a higher odds of sPTB and birth of SGA neonates [38–41].”
From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [38]
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Martin-Alonso, R., Prieto, P., Fernández‐Buhigas, I., German-Fernandez, C., Aramburu, C., Piqueras, V., Cuenca-Gómez, D., Ferrer, E., Rollé, V., Santacruz, B., et al. (2024) · Medicina · doi:10.3390/medicina60071071 · Cited by 10
“In contrast to previous studies [1,54,55], we did not find an association with preterm birth.”
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Jääskeläinen, T. J., Suomalainen‐König, S., Hämäläinen, E. K., Pulkki, K. J., Romppanen, J., Heinonen, S. T., Laivuori, H. M., & FINNPEC, F. T. (2017) · Annals of Medicine · doi:10.1080/07853890.2017.1335427 · Cited by 7
Smoking Cessation and Preterm Birth in Second Pregnancy Among Women who Smoked in Their First
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Animal Models Evaluating the Impact of Prenatal Exposure to Tobacco and Marijuana
OLYAEI, A. F., CAMPBELL, L. R., Roberts, V. H. J., & LO, J. O. (2022) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0000000000000693 · Cited by 7
Jin, W., Hughes, K. M., Sim, S., Shemer, S. A., & Sheehan, P. M. (2021) · Journal of Perinatal Medicine · doi:10.1515/jpm-2021-0020 · Cited by 7
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Smoke-Free Policies in the Global South
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“In addition, it is well known that maternal smoking during pregnancy increases not only the risk of adverse birth outcomes, such as low birth weight [8, 9], stillbirth, neonatal death, perinatal death [10], and preterm birth [11], but also their health risks such as atopic eczema [12], wheezing, and asthma [13].”
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Abide, Ç. Y., Çöğendez, E., Kumru, P., Ergen, E. B., & Kılıççı, Ç. (2018) · Zeynep Kamil Tıp Bülteni · doi:10.16948/zktipb.393346 · Cited by 5
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Comparison of the Cervical Culture Results in Preterm Labor and Premature Rupture of Membranes
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Newspaper media representation of electronic cigarette use during pregnancy
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Helping Low Income Pregnant Women Quit Smoking: Improving the First Breath Program.
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“26,33,43 In our study population, exposure to tobacco smoke during pregnancy was reported by one in ten women.”
Variation of DNA Methylation in Newborns Associated with Exhaled Carbon Monoxide during Pregnancy
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“Previous research has described associations between in utero [4] tobacco smoke exposure with severe neonatal outcomes such as prematurity [5], stillbirth [6], congenital anomalies [7], low birth weight [8], and neonatal mortality [8].”
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Dangers of smoking cigarettes and drinking alcohol during pregnancy
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Late pre-term (32 – 36 weeks) birth in a North London hospital
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“…35 years (Ancel et al. 1999), nulliparity (Bakketeig and Hoffman 1981), single marital status (Ancel et al. 1999), black race (Schoendorf et al. 1992; Mercer et al. 1996) and smoking (Berkowitz and Papiernik 1993; Shah and Bracken 2000) were not confirmed for late pre-term birth in this population.”
Background
Metadata
- Authors
- Shah, N. R., & Bracken, M. B.
- Affiliations
- Yale University (US)
- ORCID
- Shah, Nirav R.
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2000-02
- Volume
- 182
- Issue
- 2
- Pages
- 465-472
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC2706697
- OpenAlex
- W2014933068
- Cited by
- 394
- References
- 48
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 10 · 2023: 13 · 2022: 23 · 2021: 18 · 2020: 22 · 2019: 23 · 2018: 15 · 2017: 26 · 2016: 23 · 2015: 24 · 2014: 17 · 2013: 23 · 2012: 16
- FWCI
- 2.15
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (F32HL074478)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Obstetrics and Gynecology › Preterm Birth and Chorioamnionitis
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Keywords
- maternal cigarette smoking, preterm birth, smoking during pregnancy, dose-response relationship, smoking intensity, preterm birth risk factors, publication bias
- MeSH terms
- Dose-Response Relationship, Drug, Female, Gestational Age, Humans, Obstetric Labor, Premature, Pregnancy, Prospective Studies, Retrospective Studies, Smoking, Odds Ratio, Case-Control Studies, MEDLINE
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