A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis
Por:
Abraham M, Alramadhan S, Iniguez C, Duijts L, Jaddoe VW, Den Dekker HT, Crozier S, Godfrey KM, Hindmarsh P, Vik T, Jacobsen GW, Hanke W, Sobala W, Devereux G and Turner S
Publicada:
23 feb 2017
Resumen:
Background
Maternal smoking during pregnancy is linked to reduced birth weight but the gestation at onset of this relationship is not certain. We present a systematic review of the literature describing associations between maternal smoking during pregnancy and ultrasound measurements of fetal size, together with an accompanying meta-analysis.
Methods
Studies were selected from electronic databases (OVID, EMBASE and Google Scholar) that examined associations between maternal smoking or smoke exposure and antenatal fetal ultrasound measurements. Outcome measures were first, second or third trimester fetal measurements.
Results
There were 284 abstracts identified, 16 papers were included in the review and the metaanalysis included data from eight populations. Maternal smoking was associated with reduced second trimester head size (mean reduction 0.09 standard deviation (SD) [95% CI 0.01, 0.16]) and femur length (0.06 [0.01, 0.10]) and reduced third trimester head size (0.18 SD [0.13, 0.23]), femur length (0.27 SD [0.21, 0.32]) and estimated fetal weight (0.18 SD [0.11, 0.24]). Higher maternal cigarette consumption was associated with a lower z score for head size in the second (mean difference 0.09 SD [0, 0.19]) and third (0.15 SD [0.03, 0.26]) trimesters compared to lower consumption. Fetal measurements were not reduced for those whose mothers quit before or after becoming pregnant compared to mothers who had never smoked.
Conclusions
Maternal smoking during pregnancy is associated with reduced fetal measurements after the first trimester, particularly reduced head size and femur length. These effects may be attenuated if mothers quit or reduce cigarette consumption during pregnancy.
Filiaciones:
Abraham M:
Child Health, University of Aberdeen, Aberdeen, United Kingdom
Alramadhan S:
Child Health, University of Aberdeen, Aberdeen, United Kingdom
:
FISABIO - Universitat Jaume I - Universitat de València Epidemiology and Environmental Health Joint Research Unit and Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Valencia, Spain
Duijts L:
The Generation R Study, Department of Paediatrics, Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
Jaddoe VW:
The Generation R Study, Department of Paediatrics, Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
Den Dekker HT:
The Generation R Study, Department of Paediatrics, Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
Crozier S:
MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Godfrey KM:
MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Hindmarsh P:
University College London, London, United Kingdom
Vik T:
Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
Jacobsen GW:
Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
Hanke W:
Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
Sobala W:
Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
Devereux G:
Child Health, University of Aberdeen, Aberdeen, United Kingdom
Turner S:
Child Health, University of Aberdeen, Aberdeen, United Kingdom
Green Published, gold, Green Submitted, Green Accepted
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