Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China.
Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
World J Pediatr. 2022 Mar;18(3):176-185. doi: 10.1007/s12519-021-00501-5. Epub 2022 Jan 28.
Maternal smoking during pregnancy may be associated with low birth weight (LBW) in offspring and global risk estimates have not been summarized previously. We aimed to systematically explore evidence regarding maternal smoking and the LBW risk in offspring globally and examine possible causes of heterogeneity across relevant studies.
Comprehensive search of PubMed, Ovid Embase, Ovid Medline (R), and Web of science from inception until October 2021 was carried out. A random-effects meta-analysis was used to estimate the pooled odds ratio (OR) and corresponding 95% confidence interval (CI). Restricted cubic spline analysis with three knots was used to further examine the dose-response relationship.
Literature searches yielded 4940 articles, of which 53 met inclusion criteria (comprising 55 independent studies). Maternal smoking during pregnancy was significantly associated with the risk of LBW in offspring (OR = 1.89, 95% CI = 1.80-1.98). Furthermore, an obvious dose-response relationship between the amount of cigarettes daily smoked in pregnancy and the risk of LBW in offspring was observed. The results of subgroup analyses indicated that the risk of maternal smoking on LBW was larger in more recently conducted studies (P = 0.020) and longer period of active smoking during pregnancy (P = 0.002). No evidence of publication bias was found.
In summary, maternal smoking in pregnancy was significantly associated with a higher risk of LBW in offspring on a global scale. The risk of maternal smoking on infant LBW seems to be increasing over time, and was higher with longer smoking duration throughout pregnancy and more cigarettes smoked daily.
母亲在怀孕期间吸烟可能与后代的低出生体重（LBW）有关，此前尚未对全球风险估计值进行总结。我们旨在系统地探讨全球范围内母亲吸烟与后代 LBW 风险的证据，并检查相关研究中存在差异的可能原因。
从建库至 2021 年 10 月，我们对 PubMed、Ovid Embase、Ovid Medline（R）和 Web of Science 进行了全面检索。使用随机效应荟萃分析来估计汇总的优势比（OR）和相应的 95%置信区间（CI）。使用带有三个结的限制性立方样条分析进一步检查剂量-反应关系。
文献检索产生了 4940 篇文章，其中 53 篇符合纳入标准（包括 55 项独立研究）。母亲在怀孕期间吸烟与后代 LBW 的风险显著相关（OR=1.89，95%CI=1.80-1.98）。此外，还观察到怀孕期间每天吸烟量与后代 LBW 风险之间存在明显的剂量-反应关系。亚组分析的结果表明，最近进行的研究（P=0.020）和怀孕期间主动吸烟时间更长（P=0.002），母亲吸烟对 LBW 的风险更大。未发现发表偏倚的证据。
总之，母亲在怀孕期间吸烟与后代 LBW 的风险显著相关。随着时间的推移，母亲吸烟对婴儿 LBW 的风险似乎在增加，且与怀孕期间吸烟时间更长和每天吸烟更多有关。
