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
. 2019 Mar 20;9(3):e023213.
doi: 10.1136/bmjopen-2018-023213.

Impact of maternal smoking on early childhood health: a retrospective cohort linked dataset analysis of 697 003 children born in Scotland 1997-2009

Richard Lawder  1 , Bruce Whyte  2 , Rachael Wood  1   3 , Colin Fischbacher  1 , David Michael Tappin  4
Affiliations

Impact of maternal smoking on early childhood health: a retrospective cohort linked dataset analysis of 697 003 children born in Scotland 1997-2009

Richard Lawder et al. BMJ Open. .

Abstract

Objective: Smoking during pregnancy is associated with adverse health impacts on mother and child. We used a large linked Scottish dataset to produce contemporary estimates of the impact on child health, particularly hospitalisation.

Design: Retrospective cohort study linking birth, death, maternity, infant health, child health surveillance and admission records. We examined the association between smoking status at maternity booking and pregnancy outcomes, hospital admission and death during the first 5 years of life. Models were adjusted for maternal age, socioeconomic status, infant feeding, country of birth, sex, parity and delivery mode. We calculated population attributable fraction (PAF) for each outcome.

Setting: Scotland, UK.

Participants: Singleton births between 1997 and 2009 (n=697 003) followed to March 2012.

Results: 332 386 children had at least one admission by 31 March 2012. There were 56 588 born small for gestational age, 40 492 prematurely and 1074 postneonatal deaths. Within the first 5 years of life, 56 615 children had at least one admission for acute respiratory infections, 24 088 for bronchiolitis and 7549 for asthma. Maternal smoking significantly increased admission for acute respiratory infections (adjusted HR 1.29, 95% CI 1.25 to 1.34, PAF 6.7%) and bronchiolitis (HR 1.43, 95% CI 1.38 to 1.48 under 1 year, PAF 10.1%), asthma (HR 1.29, 95% CI 1.22 to 1.37 age 1-5 years, PAF 7.1%) and bacterial meningitis (HR 1.49, 95% CI 1.30 to 1.71, PAF 11.8%) age 0-5 years. Neonatal mortality (adjusted OR 1.32, 95% CI 1.17 to 1.49, PAF 6.7%), postneonatal mortality (OR 2.18, 95% CI 1.87 to 2.53, PAF 22.3%), small for gestational age (OR 2.67, 95% CI 2.62 to 2.73, PAF 27.5%) and prematurity (OR 1.41, 95% CI 1.37 to 1.44, PAF 8.8%) were higher among the offspring of smokers.

Conclusion: Smoking during pregnancy causes significant ill health and death among children born in Scotland. These findings support continued investment to reduce smoking among women before, during and after pregnancy as 50% of women will go on to have further children.

Keywords: child health; infant death; infant, small for gestational age; pregnancy; pregnancy outcome; smoking.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Admissions to hospital for children born in Scotland between 1997 and 2009.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Flenady V, Koopmans L, Middleton P, et al. . Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet 2011;377:1331–40. 10.1016/S0140-6736(10)62233-7 - DOI - PubMed
    1. ONS (Office for National Statistics). Infant and perinatal mortality in England and Wales by social and biological factors.Stat Bull 2011, Key findings www.ons.gov.uk/ons/dcp171778_300596.pdf
    1. Dietz PM, England LJ, Shapiro-Mendoza CK, et al. . Infant morbidity and mortality attributable to prenatal smoking in the U.S. Am J Prev Med 2010;39:45–52. 10.1016/j.amepre.2010.03.009 - DOI - PubMed
    1. Health Inequalities Unit, Department of Health. Review of the Health Inequalities Infant. Mortality PSA Target 2007; www.perinatal.nhs.uk/smoking/health%20inequalities%20report%202007.pdf
    1. Delpisheh A, Kelly Y, Rizwan S, et al. . Population attributable risk for adverse pregnancy outcomes related to smoking in adolescents and adults. Public Health 2007;121:861–8. 10.1016/j.puhe.2007.03.015 - DOI - PubMed

MeSH terms