TY  - JOUR
N2  - BACKGROUND: Smoking during pregnancy (SDP) and the postpartum period has serious health outcomes for the mother and infant. Although some systematic reviews have shown the impact of maternal SDP on particular conditions, a systematic review examining the overall health outcomes has not been published. Hence, this paper aimed to conduct an umbrella review on this issue. METHODS: A systematic review of systematic reviews (umbrella review) was conducted according to a protocol submitted to PROSPERO ( CRD42018086350 ). CINAHL, EMBASE, MEDLINE, PsycINFO, Web of Science, CRD Database and HMIC databases were searched to include all studies published in English by 31 December 2017, except those focusing exclusively on low-income countries. Two researchers conducted the study selection and quality assessment independently. RESULTS: The review included 64 studies analysing the relationship between maternal SDP and 46 health conditions. The highest increase in risks was found for sudden infant death syndrome, asthma, stillbirth, low birth weight and obesity amongst infants. The impact of SDP was associated with the number of cigarettes consumed. According to the causal link analysis, five mother-related and ten infant-related conditions had a causal link with SDP. In addition, some studies reported protective impacts of SDP on pre-eclampsia, hyperemesis gravidarum and skin defects on infants. The review identified important gaps in the literature regarding the dose-response association, exposure window, postnatal smoking. CONCLUSIONS: The review shows that maternal SDP is not only associated with short-term health conditions (e.g. preterm birth, oral clefts) but also some which can have life-long detrimental impacts (e.g. obesity, intellectual impairment). IMPLICATIONS: This umbrella review provides a comprehensive analysis of the overall health impacts of SDP. The study findings indicate that while estimating health and cost outcomes of SDP, long-term health impacts should be considered as well as short-term effects since studies not including the long-term outcomes would underestimate the magnitude of the issue. Also, interventions for pregnant women who smoke should consider the impact of reducing smoking due to health benefits on mothers and infants, and not solely cessation.
VL  - 21
A1  - Av?ar, TS
A1  - McLeod, H
A1  - Jackson, L
Y1  - 2021/03/26/
N1  - This work is licensed under a Creative Commons Attribution 4.0 International License. The images
or other third party material in this article are included in the Creative Commons license,
unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license,
users will need to obtain permission from the license holder to reproduce the material. To view a copy of this
license, visit http://creativecommons.org/licenses/by/4.0/
ID  - discovery10132147
AV  - public
JF  - BMC Pregnancy Childbirth
UR  - https://doi.org/10.1186/s12884-021-03729-1
TI  - Health outcomes of smoking during pregnancy and the postpartum period: an umbrella review
KW  - Health outcomes
KW  -  Partner smoking
KW  -  Smoking during pregnancy
KW  -  Systematic review
KW  -  Umbrella review
KW  -  Cleft Lip
KW  -  Cleft Palate
KW  -  Female
KW  -  Humans
KW  -  Infant Health
KW  -  Infant
KW  -  Newborn
KW  -  Maternal Health
KW  -  Mothers
KW  -  Postpartum Period
KW  -  Pregnancy
KW  -  Pregnant Women
KW  -  Premature Birth
KW  -  Prenatal Exposure Delayed Effects
KW  -  Smoking
KW  -  Smoking Prevention
KW  -  Systematic Reviews as Topic
ER  -