Meta‐analysis of the association of maternal smoking and passive smoking during pregnancy with neural tube defects

Meng, Xia; Sun, Yanxin; Duan, Wenhou; Jia, Chongqi

doi:10.1002/ijgo.12334

Cited by 36 publications

(27 citation statements)

References 31 publications

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“…By contrast, younger fathers were associated with NTD risk in our meta‐analysis, which might be due to the occurrence of unplanned pregnancies in this younger group who may not take folic acid supplementation and may engage in negative coping behaviors (Kazaura et al, 2004). Meng et al (2018) reported that passive smoking during pregnancy significantly increased the risk of NTDs. The present explanation for the young paternal age effect is that more unhealthy lifestyle among young couples may be prevalent, such as smoking and alcohol use.…”

Section: Discussionmentioning

confidence: 99%

Maternal, paternal, and neonatal risk factors for neural tube defects: A systematic review and meta‐analysis

Jia

Wei

et al. 2019

Intl J of Devlp Neuroscience

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Objective Neural tube defects [NTDs] are severe congenital anomalies. The etiology of NTDs is not fully known, and studies on the potential risk factors of NTDs present inconsistent results. Thus, we conducted a systematic review and meta‐analysis to investigate the maternal, paternal, and neonatal risk factors for NTDs. Study design We systematically reviewed relative original studies published through October 6, 2018 available in Pubmed, Embase and the Cochrane Library without restrictions for language. The selected studies measured maternal, paternal, and neonatal risk factors and examined their associations with NTDs. A meta‐analysis, including subgroup analysis and sensitivity analysis, was conducted to estimate the pooled effect measures. Two reviewers independently extracted data using a predesigned data collection form. Results Forty‐five studies were eligible for inclusion in the meta‐analysis, and twelve potential risk factors were analyzed. The factors that were associated with NTDs risk included stressful life events [odds ratio [OR],1.61; 95% confidence interval [CI], 1.24―2.08; p < 0.001; I2 = 59.2%], low maternal education level [OR, 1.42; 95% CI, 1.19―1.70; p < 0.001; I2 = 47.7%], pregestational diabetes [OR, 2.24; 95% CI, 1.21―4.12; p < 0.010; I2 = 56.3%], low paternal age [OR, 1.41; 95% CI, 1.10―1.81; p = 0.007; I2 = 0.0%], low birth weight [OR, 5.53; 95% CI, 1.95―15.70; p = 0.001; I2 = 98.5%], and neonatal female gender [OR, 1.54; 95% CI, 1.10―2.14; p = 0.012; I2 = 67.8%]. Conclusion Stressful life events, pregestational diabetes, low birth weight, and neonatal female gender are risk factors associated with NTDs. Low maternal education level and low paternal age are factors that are moderately associated with NTDs. Further cohort studies are required to verify the factors associated with NTDs and control the risk of this severe birth defect.

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Section: Discussionmentioning

confidence: 99%

Maternal, paternal, and neonatal risk factors for neural tube defects: A systematic review and meta‐analysis

Jia

Wei

et al. 2019

Intl J of Devlp Neuroscience

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“…Eleven reviews (Table 3) described the health effects of second-hand smoke exposure during pregnancy [19,26,36,42,45,[48][49][50][51][52][53], three reviews ( Table 3) described health effects of using smokeless tobacco during pregnancy [43,44,54], while two reviews (Table 3) were about health outcomes of water pipe (shisha) use during pregnancy [46,55]. Association between postnatal maternal smoking and wheezing in the past 12 months had an effect size of 1.21 (95% CI: 1.13-1.31; I 2 = 47.0%, p = 0.067).…”

Section: Risks Associated With Exposure To Tobacco and Nicotine In Otmentioning

confidence: 99%

“…Similar to active smoking by pregnant mothers, the risk of orofacial clefts in infants was also accentuated by approximately 200% when mothers were exposed to passive smoking during pregnancy [51]. Babies exposed to passive smoking also have increased odds of neural tube defect (OR 1.898; 95% CI 1.557-2.313) [36].…”

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confidence: 99%

Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting

Gould

Havard

Lim

et al. 2020

IJERPH

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The aim of this review of reviews was to collate the latest evidence from systematic reviews about the maternal and child health outcomes of being exposed to tobacco and nicotine during pregnancy; the effectiveness of interventions designed to reduce these exposures, and barriers to and facilitators of smoking cessation during pregnancy. Two databases were searched to obtain systematic reviews published from 2010 to 2019. Pertinent data from 76 articles were summarized using a narrative synthesis (PROSPERO reference: CRD42018085896). Exposure to smoke or tobacco in other forms during pregnancy is associated with an increased risk of obstetric complications and adverse health outcomes for children exposed in-utero. Counselling interventions are modestly effective, while incentive-based interventions appear to substantially increase smoking cessation. Nicotine replacement therapy is effective during pregnancy but the evidence is not conclusive. Predictors and barriers to smoking cessation in pregnancy are also discussed. Smoking during pregnancy poses substantial risk to mother’s and child’s health. Psychosocial interventions and nicotine replacement therapy (NRT) appear to be effective in helping pregnant women quit smoking. Barriers to smoking cessation must be identified and steps taken to eradicate them in order to reduce smoking among pregnant women. More research is needed on smoking cessation medications and e-cigarettes.

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“…There are many other noxious compounds in tobacco smoke that can cross the placental barrier and influence prenatal development 27 . A metaanalysis showed that women exposed to SHS during pregnancy is associated with higher risk of infants’ neural tube defects 28 .…”

Section: Discussionmentioning

confidence: 99%

The association between maternal exposure to secondhand smoke during pregnancy and their children’s cerebral palsy, Shandong, China

Ren¹,

Xie²,

Li³

et al. 2020

Tob. Induc. Dis.

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INTRODUCTION Tobacco use poses a threat to the health of pregnant women and their children. Our study assessed the association between maternal exposure to secondhand smoke (SHS) during pregnancy and children’s cerebral palsy (CP) in Shandong, China. METHODS In our observational study, 5067 mother–child pairs were included from Shandong Province, China. Mothers filled in questionnaires about exposure to SHS during pregnancy. Statistical analysis and logistic regression models were built in R program to estimate the association in adjusted odds ratio (AOR) between SHS exposure during pregnancy and risk of children’s CP, after adjustment for potential confounders including delivery mode and baby’s birthweight. RESULTS Exposure to SHS was noted among 3663 (72.3%) of the 5067 non-smoking mothers during their pregnancy. Of the 239 CP children within the study, 192 (80.3%) were exposed to SHS during pregnancy. Children born to mothers exposed to SHS during pregnancy had a higher risk of CP (AOR=1.44; 95% CI: 1.02–2.04) than those born to non-exposed mothers, the risk increased by exposure time in the logistic regression model. The association between SHS exposure during pregnancy and CP children remained significant when adjusting for delivery mode and infant’s birthweight due to their significant association with CP, with an AOR of 1.46 (95% CI: 1.13–1.91) for 1–4 days/week and 1.63 (95% CI: 1.22–2.01) for 5–7 days/week exposure to SHS. CONCLUSIONS Our study suggests that maternal exposure to secondhand smoke during pregnancy is associated with children’s CP. Future preventive interventions of CP should include strategies that target the antenatal women who are exposed to SHS.

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Meta‐analysis of the association of maternal smoking and passive smoking during pregnancy with neural tube defects

Abstract: Background: It is unclear whether the incidence of neural tube defects (NTDs) is

Cited by 36 publications

References 31 publications

Maternal, paternal, and neonatal risk factors for neural tube defects: A systematic review and meta‐analysis

Maternal, paternal, and neonatal risk factors for neural tube defects: A systematic review and meta‐analysis

Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting

The association between maternal exposure to secondhand smoke during pregnancy and their children’s cerebral palsy, Shandong, China

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