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

BMC Public Health

Research Article

Takawira C Marufu¹  Sarah Lewis¹  Anand Ahankari²  Tim Coleman³ 

[1] Division of Epidemiology and Public Health, Faculty of Medicine and Health Sciences, University of Nottingham, Clinical Sciences Building 2, Nottingham City Hospital, Hucknall Road, NG5 1 PB, Nottingham, UK;Division of Epidemiology and Public Health, Faculty of Medicine and Health Sciences, University of Nottingham, Clinical Sciences Building 2, Nottingham City Hospital, Hucknall Road, NG5 1 PB, Nottingham, UK;Halo Medical Foundation, Osmanabad, India;Division of Primary Care, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK;

关键词: Cotinine;    Maternal Smoking;    Adverse Pregnancy Outcome;    Cigarette Consumption;    Newcastle Ottawa Scale;   

DOI  :  10.1186/s12889-015-1552-5

 received in 2014-10-24, accepted in 2015-02-16,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundSmoking 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.MethodsWe searched four databases namely MEDLINE, EMBASE, Psych Info and Web of Science for all relevant original studies published until 31st December 2012. We included observational studies that measured the association between maternal smoking during pregnancy and the risk of stillbirth.Results1766 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.ConclusionOur 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.

【 授权许可】

Unknown   
© Marufu et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.