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A systematic review and meta-analysis of prospective studies on the association between maternal cigarette smoking and preterm delivery
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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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Risk Factors for Gestational Diseases
Bonis, M. D., Torricelli, M., & Petraglia, F. (2012) · Springer eBooks · doi:10.1007/978-88-470-1405-3_4
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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