Effect of maternal cigarette smoking on pregnancy complications and sudden infant death syndrome.
BACKGROUND
The purpose of this study was to estimate the annual morbidity and mortality among fetuses and infants that can be attributed to the use of tobacco products by pregnant women.


METHODS
Published research reports identified by literature review were combined in a series of meta-analyses to compute pooled risk ratios, which, in turn, were used to determine the population attributable risk.


RESULTS
Each year, use of tobacco products is responsible for an estimated 19,000 to 141,000 tobacco-induced abortions, 32,000 to 61,000 infants born with low birthweight, and 14,000 to 26,000 infants who require admission to neonatal intensive care units. Tobacco use is also annually responsible for an estimated 1900 to 4800 infant deaths resulting from perinatal disorders, and 1200 to 2200 deaths from sudden infant death syndrome (SIDS).


CONCLUSIONS
Tobacco use is an important preventable cause of abortions, low birthweight, and deaths from perinatal disorders and SIDS. All pregnant women should be advised that smoking places their unborn children in danger. The low success rate of smoking cessation among pregnant women suggests that efforts to reduce the complications of pregnancy attributable to tobacco use by pregnant women should focus on preventing nicotine addiction among teenaged girls.
DiFranza
J R
JR
Fitchburg Family Practice Residency Program, University of Massachusetts 01420, USA.
Lew
R A
RA
D000022:Abortion, Spontaneous / Q000209:etiology; D000293:Adolescent; D000328:Adult; D005260:Female; D005313:Fetal Death / Q000209:etiology; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D012907:Smoking / Q000009:adverse effects*; D000074606:Smoking Prevention; D013398:Sudden Infant Death / Q000209:etiology*