Cevik Jevan, Salehi Omar, Gaston James, Rozen Warren M
Department of Plastic and Reconstructive Surgery, Peninsula Health, Melbourne, VIC 3199, Australia.
Peninsula Clinical School, Central Clinical School, Faculty of Medicine, Monash University, Melbourne, VIC 3199, Australia.
J Clin Med. 2023 Jun 21;12(13):4181. doi: 10.3390/jcm12134181.
Maternal smoking during pregnancy has been associated with adverse effects on foetal development, including congenital limb anomalies. This systematic review aimed to provide an updated assessment of the association between maternal smoking during pregnancy and the risk of congenital limb anomalies. A systematic search was conducted to identify relevant studies published up to February 2023. Studies reporting on the relationship between maternal smoking during pregnancy and congenital digital anomalies or congenital limb reduction defects were included. Two independent reviewers screened the studies, extracted data, and assessed the quality of the included studies. Meta-analyses were performed to estimate the pooled odds ratios with 95% confidence intervals using fixed and random-effects models. In total, 37 publications comprising 11 cohort and 26 case-control studies were included in the systematic review. The meta-analysis demonstrated a significant increased risk of congenital limb reduction defects (pooled OR: 1.27, 95% CI: 1.18-1.38) in infants born to mothers who smoked during pregnancy. Similarly, a significant relationship was observed for the development of polydactyly/syndactyly/adactyly when considered as a single group (pooled OR: 1.32, 95% CI: 1.25-1.40). Yet, in contrast, no significant association was observed when polydactyly (pooled OR: 1.06, 95% CI: 0.88-1.27) or syndactyly (pooled OR: 0.91, 95% CI: 0.77-1.08) were considered individually. This systematic review provides updated evidence of a significant relationship between maternal smoking during pregnancy and increased risk of congenital limb anomalies. These findings highlight the potential detrimental effects of smoking on foetal limb development and underscore the importance of smoking cessation interventions for pregnant women to mitigate these risks.
孕期母亲吸烟与胎儿发育的不良影响有关，包括先天性肢体异常。本系统评价旨在对孕期母亲吸烟与先天性肢体异常风险之间的关联进行更新评估。进行了系统检索以识别截至2023年2月发表的相关研究。纳入了报告孕期母亲吸烟与先天性手指异常或先天性肢体减少缺陷之间关系的研究。两名独立评审员筛选了研究、提取了数据并评估了纳入研究的质量。使用固定效应模型和随机效应模型进行荟萃分析以估计合并比值比及95%置信区间。该系统评价共纳入37篇出版物，包括11项队列研究和26项病例对照研究。荟萃分析表明，孕期吸烟母亲所生婴儿出现先天性肢体减少缺陷的风险显著增加（合并比值比：1.27，95%置信区间：1.18 - 1.38）。同样，当将多指/并指/无指视为一个单一组时，观察到其发生发展存在显著关联（合并比值比：1.32，95%置信区间：1.25 - 1.40）。然而，相比之下，单独考虑多指（合并比值比：1.06，95%置信区间：0.88 - 1.27）或并指（合并比值比：0.91，95%置信区间：0.77 - 1.08）时，未观察到显著关联。本系统评价提供了更新的证据，表明孕期母亲吸烟与先天性肢体异常风险增加之间存在显著关系。这些发现凸显了吸烟对胎儿肢体发育的潜在有害影响，并强调了为孕妇开展戒烟干预措施以降低这些风险的重要性。
