Epidemiology of prenatal smoking and perinatal outcomes

doi:10.1016/j.earlhumdev.2007.08.002

Early Human Development

Volume 83, Issue 11, November 2007, Pages 713-720

https://doi.org/10.1016/j.earlhumdev.2007.08.002 Get rights and content

Abstract

During the previous two decades smoking among pregnant women in the developed world declined by about 60–75%. Nevertheless, prenatal smoking remains a common habit and accounts for a significant proportion of fetal morbidity and mortality through both a direct (fetal) and an indirect (placental) effect. The most important smoking-induced placental pathology is placental abruption with reported risk estimates ranging from 1.4 to 4.0. It is almost a consensus that prenatal smoking is a causative factor for placental abruption. Although the evidence is less compelling, smoking mothers are at an increased risk for placenta previa and placenta-previa–accreta combination. There is no association between maternal smoking and the syndrome of idiopathic uterine bleeding. The relationship between maternal smoking and fetal growth is causal, and includes significant reduction in growth of head circumference, abdominal circumference and femur length, with the largest reduction in size observed for femur length. Prenatal smoking is associated with a 20–30% higher likelihood for stillbirth, a 40% elevation in the risk for infant mortality and a 2-fold increase in the incidence of SIDS.

Conclusion:

Despite a temporal decline in maternal smoking, it still accounts for significant feto-infant morbidity and mortality, and efforts to discourage prenatal smoking need to be intensified.

Section snippets

Epidemiology

It is well established that maternal smoking frequently results in poor birth and reproductive outcomes including but not limited to preterm birth, intrauterine growth restriction and various placental conditions [1], [2]. Despite the known risks, women throughout the world continue to smoke during pregnancy. In fact, most smokers do not quit when they become pregnant. A Canadian study reported 33% of women smoked before pregnancy and nearly 70% of these women were still smokers at the time of

Conclusion and future directions

Active smoking during pregnancy impairs normal fetal growth and development leading to adverse perinatal outcomes. However, epidemiological evidence for the effects of passive smoking on the feto-placental unit remains indecisive, and further refined studies are needed in this domain. While the literature provides ample information on the impact of prenatal smoking on singleton pregnancies, very little has been reported on multiples. It will also be of interest to compare the toxic effects of

Acknowledgements

This work was supported through a Young Clinical Scientist Award to Dr. Hamisu Salihu by the Flight Attendant Medical Research Institute (FAMRI). The funding agency did not play any role in any aspect of the study.

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Epidemiology of prenatal smoking and perinatal outcomes

Abstract

Conclusion:

Section snippets

Epidemiology

Conclusion and future directions

Acknowledgements

Am J Obstet Gynecol

Am J Obstet Gynecol

Am J Obstet Gynecol

Am J Obstet Gynecol

Am J Prev Med

Early Hum Dev

Am J Obstet Gynecol

Am J Obstet Gynecol

Am J Obstet Gynecol

Eur J Obstet Gynecol Reprod Biol

Am J Obstet Gynecol

Am J Pathol

Lancet

Neurotoxicol Teratol

Smoking during pregnancy and preterm birth according to obstetric history: French national perinatal surveys

Paediatr Perinat Epidemiol

Maternal cigarette smoking as a risk factor for placental abruption, placenta previa, and uterine bleeding in pregnancy

Am J Epidemiol

The natural history of smoking during pregnancy among women in Nova Scotia

CMAJ

Women and smoking: an update for the 1990s

Am J Obstet Gynecol

Smoking during pregnancy in the 1990s

Natl Vital Stat Rep

Prevalence of smoking among pregnant women in Nova Scotia from 1988 to 1992

CMAJ

Effectiveness of bupropion for smoking cessation during pregnancy

J Addict Dis

Adolescent smoking in pregnancy and birth outcomes

Eur J Public Health

Perinatal events associated with maternal smoking during pregnancy

Am J Epidemiol

Placenta previa, maternal smoking and recurrence risk

Acta Obstet Gynecol Scand

Gross differences observed in the placentas of smokers and nonsmokers

Am J Epidemiol

Placental abruption (abruptio placentae): the family practice notebook

Smoking during pregnancy, stillbirth and abruptio placentae

Biomedicine

The relationship of abruptio placentae with maternal smoking and small for gestational age infants

Obstet Gynecol

Placental abruption among singleton and twin births in the United States

Am J Epidemiol