Cited by 282Prenatal Substance Exposure EffectsSmoking Behavior and CessationPregnancy and preeclampsia studies

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A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis

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Abraham, Miriam, Alramadhan, Salem, Iniguez, Carmen, Duijts, Liesbeth, Jaddoe, Vincent W. V., Den Dekker, Herman T., Crozier, Sarah, Godfrey, Keith M., Hindmarsh, Peter, Vik, Torstein, Jacobsen, Geir W., Hanke, Wojciech, Sobala, Wojciech, Devereux, Graham, Turner, Steve·2017·PLOS ONE

DOI 10.1371/journal.pone.0170946PMC PMC5322900

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Abstract

BACKGROUND: Maternal smoking during pregnancy is linked to reduced birth weight but the gestation at onset of this relationship is not certain. We present a systematic review of the literature describing associations between maternal smoking during pregnancy and ultrasound measurements of fetal size, together with an accompanying meta-analysis. METHODS: Studies were selected from electronic databases (OVID, EMBASE and Google Scholar) that examined associations between maternal smoking or smoke exposure and antenatal fetal ultrasound measurements. Outcome measures were first, second or third trimester fetal measurements. RESULTS: There were 284 abstracts identified, 16 papers were included in the review and the meta-analysis included data from eight populations. Maternal smoking was associated with reduced second trimester head size (mean reduction 0.09 standard deviation (SD) [95% CI 0.01, 0.16]) and femur length (0.06 [0.01, 0.10]) and reduced third trimester head size (0.18 SD [0.13, 0.23]), femur length (0.27 SD [0.21, 0.32]) and estimated fetal weight (0.18 SD [0.11, 0.24]). Higher maternal cigarette consumption was associated with a lower z score for head size in the second (mean difference 0.09 SD [0, 0.19]) and third (0.15 SD [0.03, 0.26]) trimesters compared to lower consumption. Fetal measurements were not reduced for those whose mothers quit before or after becoming pregnant compared to mothers who had never smoked. CONCLUSIONS: Maternal smoking during pregnancy is associated with reduced fetal measurements after the first trimester, particularly reduced head size and femur length. These effects may be attenuated if mothers quit or reduce cigarette consumption during pregnancy.

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Authors: Abraham, M., Alramadhan, S., Iniguez, C., Duijts, L., Jaddoe, V. W. V., Den Dekker, H. T., Crozier, S., Godfrey, K. M., Hindmarsh, P., Vik, T., Jacobsen, G. W., Hanke, W., Sobala, W., Devereux, G., & Turner, S.
Affiliations: University of Aberdeen (GB)
Erasmus MC (NL)
University Hospital Southampton NHS Foundation Trust (GB)
University College London (GB)
Norwegian University of Science and Technology (NO)
Nofer Institute of Occupational Medicine (PL)
Corresponding author: Turner, Steve
ORCID: Duijts, Liesbeth
Jaddoe, Vincent W. V.
Den Dekker, Herman T.
Crozier, Sarah
Godfrey, Keith M.
Hindmarsh, Peter
Vik, Torstein
Jacobsen, Geir W.
Hanke, Wojciech
Sobala, Wojciech
Devereux, Graham
Turner, Steve
Venue: PLOS ONE
Publisher: Public Library of Science (PLoS)
Published: 2017-02-23
Volume: 12
Issue: 2
Pages: e0170946
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0170946
PMC: PMC5322900
OpenAlex: W2589713358
Cited by: 282
References: 35
Citations by year: 2026: 13 · 2025: 23 · 2024: 36 · 2023: 41 · 2022: 30 · 2021: 56 · 2020: 36 · 2019: 20 · 2018: 23 · 2017: 3
FWCI: 4.20
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: PLoS ONE (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
BIBSYS Brage (BIBSYS (Norway)) (acceptedVersion, cc-by)
ePrints Soton (University of Southampton) (acceptedVersion)
Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
RePEc: Research Papers in Economics (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Figshare (submittedVersion, cc-by)
Funders: European Cooperation in Science and Technology
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Keywords: smoking during pregnancy, fetal growth, fetal head circumference, femur length, estimated fetal weight, cigarette consumption, smoking cessation, prenatal tobacco exposure, birth weight
MeSH terms: Birth Weight, Female, Fetal Growth Retardation, Head, Humans, Pregnancy, Pregnancy Trimester, First, Pregnancy Trimester, Second, Pregnancy Trimester, Third, Smoking, Tobacco Smoke Pollution, Fetal Development

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A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis

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