Active or passive maternal smoking increases the risk of low birth weight or preterm delivery: Benefits of cessation and tobacco control policies

Abstract

In France, maternal smoking, active or passive, remains one of the highest in Europe. At the same time, there is an increase in the number of low birth weight (<2500 g) and premature (<37 weeks of amenorrhea) newborns. The objective of this narrative review is to examine the impact of active or passive maternal smoking on birth weight or prematurity rates, and to consider the benefits of policies to stop or control smoking. This is a narrative review that analyzes and discusses the major articles published over the past 20 years regarding the role of active or passive maternal smoking on the risk of low birth weight or preterm delivery. Articles were selected using the following keywords: maternal smoking, low birth weight, preterm birth, smoking cessation, passive smoking, exhaled carbon monoxide, tobacco control policies. Active smoking is associated, in a dose-response relationship, with increased risks of low birth weight and preterm delivery. Passive smoking, mainly related to the presence of a smoking spouse, increases the risk of low birth weight and preterm birth. Our review confirmed also the benefits of smoking cessation, even in the third trimester, in reducing the risk of small for gestation age or fetal growth restriction and preterm birth. Several studies of tobacco control policies have been shown to be effective in significantly reducing maternal smoking. There is sufficient evidence to infer a causal link between active or passive maternal smoking and low birth weight or preterm delivery. This causal link is compelling and sufficient to justify intensifying efforts to promote rapid progress in tobacco control policies, with the vision of a tobacco-free generation, and smoking cessation with best practices during preconception or pregnancy.

The effect of active and passive smoking during pregnancy on birth outcomes: A cohort study in Shanghai

“…Our study shows that active smoking during pregnancy was more harmful to maternal and infant health than passive smoking, which is consistent with previous research 12 , 16 , 23 . Studies have shown that newborns of pregnant women who actively smoke are more likely to be born preterm, have a low birth weight, and experience intrauterine growth restriction.…”

“…Previous studies have shown that active and passive smoking during pregnancy significantly increase the risk of adverse pregnancy outcomes, such as preterm birth, low birth weight 12 , fetal complications 13 , and perinatal death 14 . This study confirms that active and passive smoking increase the risk of adverse pregnancy outcomes in Shanghai, China.…”

Risk factors of necrotizing enterocolitis among neonates admitted to the neonatal intensive care unit at the selected public hospitals in southern Ethiopia, 2023

“…Other studies conducted in Louisville ( 43 ) and Canada ( 8 ) also revealed that smoking cigarettes during their pregnancy was significantly associated with necrotizing enterocolitis. Pieces of evidence revealed that smoking during pregnancy is a well-established risk factor that increases the likelihood of adverse pregnancy outcomes, including preterm birth and low birth weight ( 44 , 45 ). These factors, in turn, increase the risk of developing NEC.…”

Is Exercise during Pregnancy a Risk for Gestational Age and Preterm Delivery? Systematic Review and Meta-Analysis

“…From an epidemiological standpoint, when examining the underlying causes of the beneficial impact of physical exercise on gestational age, we encountered ample evidence to support a causal association between unhealthy lifestyles-such as excessive maternal weight gain, obesity, and smoking-and the occurrence of preterm delivery [81][82][83].…”