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Associations between Passive Maternal Smoking during Pregnancy and Preterm Birth: Evidence from a Meta-Analysis of Observational Studies

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  • Hong Cui
  • Ting-Ting Gong
  • Cai-Xia Liu
  • Qi-Jun Wu

Abstract

Previous studies investigating the relationship between passive maternal smoking and preterm birth reveal inconsistent results. We conducted the current meta-analysis of observational studies to evaluate the relationship between passive maternal smoking and preterm birth. We identified relevant studies by searching PubMed, EMBASE, and ISI Web of Science databases. We used random-effects models to estimate summary odds ratios (SORs) and 95% confidence intervals (CIs) for aforementioned association. For the analysis, we included 24 studies that involved a total of 5607 women who experienced preterm birth. Overall, the SORs of preterm birth for women who were ever exposed to passive smoking versus women who had never been exposed to passive smoking at any place and at home were 1.20 (95%CI = 1.07–1.34,I2 = 36.1%) and 1.16 (95%CI = 1.04–1.30,I2 = 4.4%), respectively. When we conducted a stratified analysis according to study design, the risk estimate was slightly weaker in cohort studies (SOR = 1.10, 95%CI = 1.00–1.21,n = 16) than in cross-sectional studies (SOR = 1.47, 95%CI = 1.23–1.74,n = 5). Additionally, the associations between passive maternal smoking and preterm birth were statistically significant for studies conducted in Asia (SOR = 1.26, 95%CI = 1.05–1.52), for studies including more than 100 cases of preterm birth (SOR = 1.22, 95%CI = 1.05–1.41), and for studies adjusted for maternal age (SOR = 1.27,95%CI = 1.09–1.47), socioeconomic status and/or education (SOR = 1.28, 95%CI = 1.10–1.49), body mass index (SOR = 1.33, 95%CI = 1.04–1.71), and parity (SOR = 1.27, 95%CI = 1.13–1.43). Our findings demonstrate that passive maternal smoking is associated with an increased risk of preterm birth. Future prospective cohort studies are warranted to provide more detailed results stratified by passive maternal smoking during different trimesters of pregnancy and by different types and causes of preterm birth.

Suggested Citation

  • Hong Cui & Ting-Ting Gong & Cai-Xia Liu & Qi-Jun Wu, 2016. "Associations between Passive Maternal Smoking during Pregnancy and Preterm Birth: Evidence from a Meta-Analysis of Observational Studies," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-18, January.
    • Handle: RePEc:plo:pone00:0147848
    DOI: 10.1371/journal.pone.0147848
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    2. Eskenazi, B. & Prehn, A.W. & Christianson, R.E., 1995. "Passive and active maternal smoking as measured by serum cotinine: The effect on birthweight," American Journal of Public Health, American Public Health Association, vol. 85(3), pages 395-398.
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    1. Alicia Alemán & Paola Morello & Mercedes Colomar & Laura Llambi & Mabel Berrueta & Luz Gibbons & Pierre Buekens & Fernando Althabe, 2016. "Brief Counseling on Secondhand Smoke Exposure in Pregnant Women in Argentina and Uruguay," IJERPH, MDPI, vol. 14(1), pages 1-11, December.
    2. Susanne Steinle & Helinor J. Johnston & Miranda Loh & William Mueller & Sotiris Vardoulakis & Kraichat Tantrakarnapa & John W. Cherrie, 2020. "In Utero Exposure to Particulate Air Pollution during Pregnancy: Impact on Birth Weight and Health through the Life Course," IJERPH, MDPI, vol. 17(23), pages 1-13, December.
    3. Nguyen N Rang & Tran Q Hien & Ton Q Chanh & Tran K Thuyen, 2020. "Preterm birth and secondhand smoking during pregnancy: A case–control study from Vietnam," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-8, October.
    4. Xia Xiao & Yan Li & Xiaoxiao Song & Qinghua Xu & Siwei Yang & Jie Wu & Edmund Seto, 2018. "Discrepancy between Self-Reported and Urine Cotinine-Verified Environmental Tobacco Smoke Exposure among Rural Pregnant Women in China," IJERPH, MDPI, vol. 15(7), pages 1-11, July.
    5. Lubica Argalasova & Ingrid Zitnanova & Diana Vondrova & Monika Dvorakova & Lucia Laubertova & Jana Jurkovicova & Juraj Stofko & Michael Weitzman & Iveta Waczulikova & Martin Simko, 2019. "Self-Reported Exposure to ETS (Environmental Tobacco Smoke), Urinary Cotinine, and Oxidative Stress Parameters in Pregnant Women—The Pilot Study," IJERPH, MDPI, vol. 16(9), pages 1-14, May.
    6. Meng Li & Reiko Okamoto & Aoki Tada & Misaki Kiya, 2020. "Factors Associated with Prenatal Smoking Cessation Interventions among Public Health Nurses in Japan," IJERPH, MDPI, vol. 17(17), pages 1-14, August.
    7. Catherine Hayes & Morgan Kearney & Helen O’Carroll & Lina Zgaga & Michael Geary & Cecily Kelleher, 2016. "Patterns of Smoking Behaviour in Low-Income Pregnant Women: A Cohort Study of Differential Effects on Infant Birth Weight," IJERPH, MDPI, vol. 13(11), pages 1-15, October.
    8. Gillian S. Gould & Alys Havard & Ling Li Lim & The PSANZ Smoking in Pregnancy Expert Group & Ratika Kumar, 2020. "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," IJERPH, MDPI, vol. 17(6), pages 1-34, March.
    9. Julia C. Schechter & Bernard F. Fuemmeler & Cathrine Hoyo & Susan K. Murphy & Junfeng (Jim) Zhang & Scott H. Kollins, 2018. "Impact of Smoking Ban on Passive Smoke Exposure in Pregnant Non-Smokers in the Southeastern United States," IJERPH, MDPI, vol. 15(1), pages 1-16, January.
    10. Hajdu, Tamás & Hajdu, Gábor, 2018. "Smoking ban and health at birth: Evidence from Hungary," Economics & Human Biology, Elsevier, vol. 30(C), pages 37-47.

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