Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2015 Mar 13:15:239.
doi: 10.1186/s12889-015-1552-5.

Maternal smoking and the risk of still birth: systematic review and meta-analysis

Takawira C Marufu  1 , Anand Ahankari  2   3 , Tim Coleman  4 , Sarah Lewis  5
Affiliations
Meta-Analysis

Maternal smoking and the risk of still birth: systematic review and meta-analysis

Takawira C Marufu et al. BMC Public Health. .

Abstract

Background: Smoking in pregnancy is known to be associated with a range of adverse pregnancy outcomes, yet there is a high prevalence of smoking among pregnant women in many countries, and it remains a major public health concern. We have conducted a systematic review and meta-analysis to provide contemporary estimates of the association between maternal smoking in pregnancy and the risk of stillbirth.

Methods: We searched four databases namely MEDLINE, EMBASE, Psych Info and Web of Science for all relevant original studies published until 31(st) December 2012. We included observational studies that measured the association between maternal smoking during pregnancy and the risk of stillbirth.

Results: 1766 studies were screened for title analysis, of which 34 papers (21 cohorts, 8 case controls and 5 cross sectional studies) met the inclusion criteria. In meta-analysis smoking during pregnancy was significantly associated with a 47% increase in the odds of stillbirth (OR 1.47, 95% CI 1.37, 1.57, p < 0.0001). In subgroup analysis, smoking 1-9 cig/day and ≥10 cig/day was associated with an 9% and 52% increase in the odds of stillbirth respectively. Subsequently, studies defining stillbirth at ≥ 20 weeks demonstrated a 43% increase in odds for smoking mothers compared to mothers who do not smoke, (OR 1.43, 95% CI 1.32, 1.54, p < 0.0001), whereas studies with stillbirth defined at ≥ 24 weeks and ≥ 28 weeks showed 58% and 33% increase in the odds of stillbirth respectively.

Conclusion: Our review confirms a dose-response effect of maternal smoking in pregnancy on risk of stillbirth. To minimise the risk of stillbirth, reducing current smoking prevalence in pregnancy should continue to be a key public health high priority.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow diagram of included and excluded studies.
Figure 2
Figure 2
Maternal smoking in pregnancy and the risk of stillbirth.
Figure 3
Figure 3
Stillbirth risk according to the amount of daily cigarette consumption.
Figure 4
Figure 4
Maternal smoking and the risk of stillbirth according to the gestation period.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organisation (WHO) Recommendations for the prevention and management of tobacco use and second- hand smoke exposure in pregnancy. Geneva: World Health Organization; 2013. - PubMed
    1. Royal College of Physicians . Passive smoking and children: a report of the Tobacco Advisory Group of the Royal College of Physicians. London: Royal College of Physicians; 2013.
    1. Royal College of Physicians . Smoking and the young. London: Royal college of Physicians; 1992.
    1. Cnattingius S, Bergstrom R, Lipworth L, Kramer MS. Pre-pregnancy weight and the risk of adverse pregnancy outcomes. N Eng J Med. 1998;338:147–52. doi: 10.1056/NEJM199801153380302. - DOI - PubMed
    1. Fretts RC. Etiology and prevention of stillbirth. Am J Obstet Gynecol. 2005;193:1923–35. doi: 10.1016/j.ajog.2005.03.074. - DOI - PubMed

Publication types