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Meta-Analysis
. 2008 Feb;32(2):201-10.
doi: 10.1038/sj.ijo.0803760. Epub 2007 Nov 27.

Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis

E Oken  1 , E B Levitan, M W Gillman
Affiliations
Meta-Analysis

Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis

E Oken et al. Int J Obes (Lond). 2008 Feb.

Abstract

Objective: Perform a systematic review of studies reporting on the association between maternal prenatal cigarette smoking and child overweight.

Design: Meta-analysis of observational studies.

Data sources: Medline search and review of reference lists among studies published through June 2006.

Review methods: Included studies reported an association between maternal smoking during pregnancy and risk of overweight among children at least 2 years of age. We did not include in the meta-analysis studies that provided only a continuous measure of adiposity, although those studies are discussed separately.

Results: Based on results of 84 563 children reported in 14 observational studies, children whose mothers smoked during pregnancy were at elevated risk for overweight (pooled adjusted odds ratio (OR) 1.50, 95% CI: 1.36, 1.65) at ages 3-33 years, compared with children whose mothers did not smoke during pregnancy. The pooled estimate from unadjusted odds ratios (OR 1.52, 95% CI: 1.36, 1.69) was similar to the adjusted estimate, suggesting that sociodemographic and behavioral differences between smokers and nonsmokers did not explain the observed association. Although we observed evidence for publication bias, simulating a symmetric set of studies yielded a similar estimate (OR 1.40, 95% CI: 1.26, 1.55).

Conclusions: Prenatal smoking exposure appears to increase rates of overweight in childhood. In parts of the world undergoing the epidemiologic transition, the continuing increase in smoking among young women could contribute to spiraling increases in rates of obesity-related health outcomes in the 21st century.

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Figures

Figure 1
Figure 1
Flow diagram showing the number of studies included in and excluded from the meta-analysis.
Figure 2
Figure 2
Results of meta-analysis of maternal smoking during pregnancy and child overweight. Individual study estimates are indicated by boxes with 95% CIs indicated by lines. The size of the box is inversely proportional to the variance. The pooled estimate is represented by the diamond, with the width of the diamond representing the pooled CI (pooled OR 1.50, 95% CI: 1.36, 1.65).
Figure 3
Figure 3
Begg’s funnel plot with pseudo 95% CIs. Filled circles indicate observed data, and open squares indicate simulated data.
See this image and copyright information in PMC

References

    1. Department of Health and Human Services CfDCaP . Tobacco Control State Highlights 2002: Impact and Opportunity. Office on Smoking and Health; Atlanta, GA: 2002.
    1. Orleans CT, Barker DC, Kaufman NJ, Marx JF. Helping pregnant smokers quit: meeting the challenge in the next decade. Tob Control. 2000;9(Suppl 3):III6–III11. - PMC - PubMed
    1. Taylor TLD, Bryant A, Keyse L, McDuff TJ. Smoking-Related Behavior and Attitudes, 2005. Office for National Statistics; London: 2006.
    1. Hamilton BE, Martin JA, Sutton PD. Births: Preliminary data for 2003. National Vital Statistics Reports. 2004;53:1–18. - PubMed
    1. Samet J, Young SY. Women and the Tobacco Epidemic: Challenges for the 21st Century. World Health Organization; Geneva: 2001.

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