title: Maternal smoking during pregnancy and birth defects in children: a systematic review with meta-analysis.
abstract: This systematic review aimed to investigate the association between maternal smoking during pregnancy and birth defects in children. We performed an electronic search of observational studies in the databases ovid MEDLINE (1950 to April 2010), LILACS and SciELO. We included 188 studies with a total of 13,564,914 participants (192,655 cases). Significant positive associations were found between maternal smoking and birth defects in the following body systems: cardiovascular (OR: 1.11; 95%CI: 1.03-1.19), digestive (OR: 1.18; 95%CI: 1.07-1.30), musculoskeletal (OR: 1.27; 95%CI: 1.16-1.39) and face and neck (OR: 1.28; 95%CI: 1.19-1.37). The strength of association between maternal smoking and birth defects measured by the OR (95%CI) is significantly related to the amount of cigarettes smoked daily (χ2 = 12.1; df = 2; p = 0.002). In conclusion, maternal smoking during pregnancy is associated with congenital malformations in children and this association is dose-dependent.
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Brazil.
authors.forename: Dilvania
authors.initials: D
authors.lastname: Nicoletti
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Brazil.
authors.forename: Leilane Droppa
authors.initials: LD
authors.lastname: Appel
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Brazil.
authors.forename: Pedro
authors.initials: P
authors.lastname: Siedersberger Neto
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Brazil.
authors.forename: Gabriel Waihrich
authors.initials: GW
authors.lastname: Guimarães
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Brazil.
authors.forename: Linjie
authors.initials: L
authors.lastname: Zhang
mesh_terms: D002648:Child; D000013:Congenital Abnormalities / Q000209:etiology*; D005260:Female; D006801:Humans; D018811:Maternal Exposure / Q000009:adverse effects*; D064887:Observational Studies as Topic; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*