Maternal smoking during pregnancy and birth defects in children: a systematic review with meta-analysis

Nicoletti, Dilvânia; Appel, Leilane Droppa; Neto, Pedro Siedersberger; Guimarães, Gabriel Waihrich; Zhang, Linjie

doi:10.1590/0102-311x00115813

Cited by 30 publications

(29 citation statements)

References 189 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Smoking tobacco during pregnancy can increase the chances of LBW by 200% (OR = 2.00, 95% CI: 1.77-2.26) [33]. Smoking was associated with a 10-30% increased risk of congenital birth defects including cardiovascular, digestive, musculoskeletal and face and neck defects, with a dose-response relationship [20,22]. The risk of spina bifida increased by over 50% for newborns whose mothers smoked during pregnancy (OR 1.55, 95 % CI = 1.06-2.26) [23].…”

Section: Risks For Foetus and Childmentioning

confidence: 99%

Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting

Gould

Havard

Lim

et al. 2020

IJERPH

View full text Add to dashboard Cite

The aim of this review of reviews was to collate the latest evidence from systematic reviews about the maternal and child health outcomes of being exposed to tobacco and nicotine during pregnancy; the effectiveness of interventions designed to reduce these exposures, and barriers to and facilitators of smoking cessation during pregnancy. Two databases were searched to obtain systematic reviews published from 2010 to 2019. Pertinent data from 76 articles were summarized using a narrative synthesis (PROSPERO reference: CRD42018085896). Exposure to smoke or tobacco in other forms during pregnancy is associated with an increased risk of obstetric complications and adverse health outcomes for children exposed in-utero. Counselling interventions are modestly effective, while incentive-based interventions appear to substantially increase smoking cessation. Nicotine replacement therapy is effective during pregnancy but the evidence is not conclusive. Predictors and barriers to smoking cessation in pregnancy are also discussed. Smoking during pregnancy poses substantial risk to mother’s and child’s health. Psychosocial interventions and nicotine replacement therapy (NRT) appear to be effective in helping pregnant women quit smoking. Barriers to smoking cessation must be identified and steps taken to eradicate them in order to reduce smoking among pregnant women. More research is needed on smoking cessation medications and e-cigarettes.

show abstract

Section: Risks For Foetus and Childmentioning

confidence: 99%

Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting

Gould

Havard

Lim

et al. 2020

IJERPH

View full text Add to dashboard Cite

show abstract

“…To decrease the prevalence of congenital anomalies, it is important to identify modifiable environmental factors and prevent maternal exposure to harmful factors. Examples of environmental factors known to increase the risk of having a child with a congenital anomaly include smoking during pregnancy (Nicoletti et al , 2014) and increased body mass index (BMI) (Stothard et al , 2009; Nicoletti et al , 2014). Air pollution is another factor that has been associated with development of congenital anomalies, in particular with congenital heart defects (Vrijheid et al , 2011).…”

Section: Introductionmentioning

confidence: 99%

Congenital anomalies in the offspring of occupationally exposed mothers: a systematic review and meta-analysis of studies using expert assessment for occupational exposures

et al. 2019

View full text Add to dashboard Cite

STUDY QUESTION Is there an association between maternal occupational exposure to solvents, pesticides and metals as assessed by expert-based assessment and congenital anomalies in the offspring? SUMMARY ANSWER There is an association between maternal occupational exposure to solvents and congenital anomalies in the offspring, including neural tube defects, congenital heart defects and orofacial clefts. WHAT IS KNOWN ALREADY One important environmental risk factor for development of congenital anomalies is maternal occupational exposure to chemicals in the workplace prior to and during pregnancy. A number of studies have assessed the association with often conflicting results, possibly due to different occupational exposure assessing methods. STUDY DESIGN, SIZE, DURATION For this systematic review with meta-analysis, the search terms included maternal occupation, exposure, congenital anomalies and offspring. Electronic databases MEDLINE and EMBASE were searched for English studies up to October 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS Two reviewers independently screened all citations identified by the search. Case-control studies and cohort studies were included if (I) they reported on the association between maternal occupational exposure to solvents, pesticides or metals and congenital anomalies, and (II) assessment of occupational exposure was performed by experts. Data on study characteristics, confounders and odds ratios (ORs) were extracted from the included studies for four subgroups of congenital anomalies. Methodological quality was assessed using the Newcastle-Ottawa Scale. In the meta-analysis, random effects models were used to pool estimates. MAIN RESULTS AND THE ROLE OF CHANCE In total, 2806 titles and abstracts and 176 full text papers were screened. Finally, 28 studies met the selection criteria, and 27 studies could be included in the meta-analysis. Our meta-analysis showed that maternal occupational exposure to solvents was associated with neural tube defects (OR: 1.51, 95%CI: 1.09–2.09) and congenital heart defects (OR: 1.31, 95%CI:1.06–1.63) in the offspring. Also maternal occupational exposure to glycol ethers, a subgroup of solvents, was associated with neural tube defects (OR: 1.93, 95%CI: 1.17–3.18) and orofacial clefts (OR: 1.95, 95%CI: 1.38–2.75) in the offspring. Only one study investigated the association between maternal occupational exposure to solvents and hypospadias and found an association (OR: 3.63, 95%CI: 1.94–7.17). Results of the included studies were consistent. In our meta-analysis, we found no associations between occupational exposure to pesticides or metals and congenital anomalies in the offspring. LIMITATIONS, REASONS FOR CAUTION A limited number of studies was included, which made it impossible to calculate pooled estimates for all congenital anomalies, ana...

show abstract

“…Given the potential link between nicotine exposure and adverse fetal and pregnancy outcomes [26, 27], understanding the motivations for and patterns of e-cigarette use among pregnant women is critical. The objectives of this study were to (i) identify trajectories of e-cigarette use, and (ii) examine the longitudinal association between e-cigarette use and smoking cessation among a U.S. national cohort of pregnant smokers.…”

Section: Introductionmentioning

confidence: 99%

E-cigarettes and smoking cessation: a prospective study of a national sample of pregnant smokers

et al. 2019

View full text Add to dashboard Cite

Background Smoking during pregnancy has adverse health consequences for the mother and fetus. E-cigarettes could aid with smoking cessation but there is limited research on the prevalence and patterns of e-cigarette use, and their association with smoking cessation among pregnant smokers. Methods We conducted a secondary analysis of a randomized controlled trial of a text-messaging program for smoking cessation among a U.S. national cohort of pregnant smokers ( n = 428). Outcomes assessed were trajectories of e-cigarettes use from baseline to one-month follow-up, and longitudinal association between e-cigarette use at baseline and smoking cessation at one-month follow-up. Results At baseline, 74 (17.29%) pregnant smokers used e-cigarettes in the past 30 days and 36 (8.41%) used e-cigarettes in the past 7 days. The primary reason stated for using e-cigarettes during pregnancy was for quitting. E-cigarette use between baseline and 1-month was inconsistent. Of 36 dual-users at baseline, 20 (55.56%) stopped using e-cigarettes by the 1-month follow-up and 14 initiated e-cigarette use. There was no evidence of an association between e-cigarette use at baseline and the primary smoking cessation outcome, 7-day point prevalence abstinence [adjusted odds ratio = 0.79, 95% confidence intervals = 0.33–1.92]. Conclusions A secondary analysis of a national sample of pregnant smokers indicates that use of e-cigarettes is inconsistent and is not associated with improved smoking cessation outcomes. There is an urgent need to further examine the risk and benefits of e-cigarette use, especially during pregnancy. Electronic supplementary material The online version of this article (10.1186/s12889-019-7299-7) contains supplementary material, which is available to authorized users.

show abstract

Maternal smoking during pregnancy and birth defects in children: a systematic review with meta-analysis

Cited by 30 publications

References 189 publications

Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting

Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting

Congenital anomalies in the offspring of occupationally exposed mothers: a systematic review and meta-analysis of studies using expert assessment for occupational exposures

E-cigarettes and smoking cessation: a prospective study of a national sample of pregnant smokers

Contact Info

Product

Resources

About