A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis

Miriam Abraham, Salem Alramadhan, Carmen Iniguez, Liesbeth Duijts, Vincent W.V. Jaddoe, Herman T. Den Dekker, Sarah Crozier, Keith M. Godfrey, Peter Hindmarsh, Torstein Vik, Geir W. Jacobsen, Wojciech Hanke, Wojciech Sobala, Graham Devereux, Steve Turner

Research output: Contribution to journalReview article

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Abstract

Background Maternal smoking during pregnancy is linked to reduced birth weight but the gestation at onset of this relationship is not certain. We present a systematic review of the literature describing associations between maternal smoking during pregnancy and ultrasound measurements of fetal size, together with an accompanying meta-analysis. 


Methods Studies were selected from electronic databases (OVID, EMBASE and Google Scholar) that examined associations between maternal smoking or smoke exposure and antenatal fetal ultrasound measurements. Outcome measures were first, second or third trimester fetal measurements. 


Results There were 284 abstracts identified, 16 papers were included in the review and the meta-analysis included data from eight populations. Maternal smoking was associated with reduced second trimester head size (mean reduction 0.09 standard deviation (SD) [95% CI 0.01, 0.16]) and femur length (0.06 [0.01, 0.10]) and reduced third trimester head size (0.18SD [0.13, 0.23]), femur length (0.27 SD [0.21, 0.32]) and estimated fetal weight (0.18 SD [0.11, 0.24]). Higher maternal cigarette consumption was associated with a lower z score for head size in the second (mean difference 0.09 SD [0, 0.19]) and third (0.15 SD [0.03, 0.26]) trimesters compared to lower consumption. Fetal measurements were not reduced for those whose mothers quit before or after becoming pregnant compared to mothers who had never smoked. 


Conclusions Maternal smoking during pregnancy is associated with reduced fetal measurements after the first trimester, particularly reduced head size and femur length. These effects may be attenuated if mothers quit or reduce cigarette consumption during pregnancy.

Original languageEnglish
Article numbere0170946
Pages (from-to)1-13
Number of pages13
JournalPloS ONE
Volume12
Issue number2
DOIs
Publication statusPublished - 23 Feb 2017

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systematic review
meta-analysis
Meta-Analysis
Smoking
Mothers
pregnancy
Pregnancy
femur
cigarettes
Tobacco Products
Head
Third Pregnancy Trimester
Second Pregnancy Trimester
First Pregnancy Trimester
Femur
Ultrasonics
Femur Head
smoke
Fetal Weight
Smoke

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Abraham, M., Alramadhan, S., Iniguez, C., Duijts, L., Jaddoe, V. W. V., Dekker, H. T. D., ... Turner, S. (2017). A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis. PloS ONE, 12(2), 1-13. [e0170946]. https://doi.org/10.1371/journal.pone.0170946

A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis. / Abraham, Miriam; Alramadhan, Salem; Iniguez, Carmen; Duijts, Liesbeth; Jaddoe, Vincent W.V.; Dekker, Herman T. Den; Crozier, Sarah; Godfrey, Keith M.; Hindmarsh, Peter; Vik, Torstein; Jacobsen, Geir W.; Hanke, Wojciech; Sobala, Wojciech; Devereux, Graham; Turner, Steve.

In: PloS ONE, Vol. 12, No. 2, e0170946, 23.02.2017, p. 1-13.

Research output: Contribution to journalReview article

Abraham, M, Alramadhan, S, Iniguez, C, Duijts, L, Jaddoe, VWV, Dekker, HTD, Crozier, S, Godfrey, KM, Hindmarsh, P, Vik, T, Jacobsen, GW, Hanke, W, Sobala, W, Devereux, G & Turner, S 2017, 'A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis' PloS ONE, vol. 12, no. 2, e0170946, pp. 1-13. https://doi.org/10.1371/journal.pone.0170946
Abraham M, Alramadhan S, Iniguez C, Duijts L, Jaddoe VWV, Dekker HTD et al. A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis. PloS ONE. 2017 Feb 23;12(2):1-13. e0170946. https://doi.org/10.1371/journal.pone.0170946
Abraham, Miriam ; Alramadhan, Salem ; Iniguez, Carmen ; Duijts, Liesbeth ; Jaddoe, Vincent W.V. ; Dekker, Herman T. Den ; Crozier, Sarah ; Godfrey, Keith M. ; Hindmarsh, Peter ; Vik, Torstein ; Jacobsen, Geir W. ; Hanke, Wojciech ; Sobala, Wojciech ; Devereux, Graham ; Turner, Steve. / A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis. In: PloS ONE. 2017 ; Vol. 12, No. 2. pp. 1-13.
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abstract = "Background Maternal smoking during pregnancy is linked to reduced birth weight but the gestation at onset of this relationship is not certain. We present a systematic review of the literature describing associations between maternal smoking during pregnancy and ultrasound measurements of fetal size, together with an accompanying meta-analysis. Methods Studies were selected from electronic databases (OVID, EMBASE and Google Scholar) that examined associations between maternal smoking or smoke exposure and antenatal fetal ultrasound measurements. Outcome measures were first, second or third trimester fetal measurements. Results There were 284 abstracts identified, 16 papers were included in the review and the meta-analysis included data from eight populations. Maternal smoking was associated with reduced second trimester head size (mean reduction 0.09 standard deviation (SD) [95{\%} CI 0.01, 0.16]) and femur length (0.06 [0.01, 0.10]) and reduced third trimester head size (0.18SD [0.13, 0.23]), femur length (0.27 SD [0.21, 0.32]) and estimated fetal weight (0.18 SD [0.11, 0.24]). Higher maternal cigarette consumption was associated with a lower z score for head size in the second (mean difference 0.09 SD [0, 0.19]) and third (0.15 SD [0.03, 0.26]) trimesters compared to lower consumption. Fetal measurements were not reduced for those whose mothers quit before or after becoming pregnant compared to mothers who had never smoked. Conclusions Maternal smoking during pregnancy is associated with reduced fetal measurements after the first trimester, particularly reduced head size and femur length. These effects may be attenuated if mothers quit or reduce cigarette consumption during pregnancy.",
author = "Miriam Abraham and Salem Alramadhan and Carmen Iniguez and Liesbeth Duijts and Jaddoe, {Vincent W.V.} and Dekker, {Herman T. Den} and Sarah Crozier and Godfrey, {Keith M.} and Peter Hindmarsh and Torstein Vik and Jacobsen, {Geir W.} and Wojciech Hanke and Wojciech Sobala and Graham Devereux and Steve Turner",
note = "Funding: The study was supported by the European Cooperation in Science and Technology, who provided funds for publication. KMG is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and by the European Union's Seventh Framework Programme (FP7/2007-2013), projects Early Nutrition and ODIN under grant agreement numbers 289346 and 613977.",
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T1 - A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis

AU - Abraham, Miriam

AU - Alramadhan, Salem

AU - Iniguez, Carmen

AU - Duijts, Liesbeth

AU - Jaddoe, Vincent W.V.

AU - Dekker, Herman T. Den

AU - Crozier, Sarah

AU - Godfrey, Keith M.

AU - Hindmarsh, Peter

AU - Vik, Torstein

AU - Jacobsen, Geir W.

AU - Hanke, Wojciech

AU - Sobala, Wojciech

AU - Devereux, Graham

AU - Turner, Steve

N1 - Funding: The study was supported by the European Cooperation in Science and Technology, who provided funds for publication. KMG is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and by the European Union's Seventh Framework Programme (FP7/2007-2013), projects Early Nutrition and ODIN under grant agreement numbers 289346 and 613977.

PY - 2017/2/23

Y1 - 2017/2/23

N2 - Background Maternal smoking during pregnancy is linked to reduced birth weight but the gestation at onset of this relationship is not certain. We present a systematic review of the literature describing associations between maternal smoking during pregnancy and ultrasound measurements of fetal size, together with an accompanying meta-analysis. Methods Studies were selected from electronic databases (OVID, EMBASE and Google Scholar) that examined associations between maternal smoking or smoke exposure and antenatal fetal ultrasound measurements. Outcome measures were first, second or third trimester fetal measurements. Results There were 284 abstracts identified, 16 papers were included in the review and the meta-analysis included data from eight populations. Maternal smoking was associated with reduced second trimester head size (mean reduction 0.09 standard deviation (SD) [95% CI 0.01, 0.16]) and femur length (0.06 [0.01, 0.10]) and reduced third trimester head size (0.18SD [0.13, 0.23]), femur length (0.27 SD [0.21, 0.32]) and estimated fetal weight (0.18 SD [0.11, 0.24]). Higher maternal cigarette consumption was associated with a lower z score for head size in the second (mean difference 0.09 SD [0, 0.19]) and third (0.15 SD [0.03, 0.26]) trimesters compared to lower consumption. Fetal measurements were not reduced for those whose mothers quit before or after becoming pregnant compared to mothers who had never smoked. Conclusions Maternal smoking during pregnancy is associated with reduced fetal measurements after the first trimester, particularly reduced head size and femur length. These effects may be attenuated if mothers quit or reduce cigarette consumption during pregnancy.

AB - Background Maternal smoking during pregnancy is linked to reduced birth weight but the gestation at onset of this relationship is not certain. We present a systematic review of the literature describing associations between maternal smoking during pregnancy and ultrasound measurements of fetal size, together with an accompanying meta-analysis. Methods Studies were selected from electronic databases (OVID, EMBASE and Google Scholar) that examined associations between maternal smoking or smoke exposure and antenatal fetal ultrasound measurements. Outcome measures were first, second or third trimester fetal measurements. Results There were 284 abstracts identified, 16 papers were included in the review and the meta-analysis included data from eight populations. Maternal smoking was associated with reduced second trimester head size (mean reduction 0.09 standard deviation (SD) [95% CI 0.01, 0.16]) and femur length (0.06 [0.01, 0.10]) and reduced third trimester head size (0.18SD [0.13, 0.23]), femur length (0.27 SD [0.21, 0.32]) and estimated fetal weight (0.18 SD [0.11, 0.24]). Higher maternal cigarette consumption was associated with a lower z score for head size in the second (mean difference 0.09 SD [0, 0.19]) and third (0.15 SD [0.03, 0.26]) trimesters compared to lower consumption. Fetal measurements were not reduced for those whose mothers quit before or after becoming pregnant compared to mothers who had never smoked. Conclusions Maternal smoking during pregnancy is associated with reduced fetal measurements after the first trimester, particularly reduced head size and femur length. These effects may be attenuated if mothers quit or reduce cigarette consumption during pregnancy.

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