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American Journal of Public Health logoLink to American Journal of Public Health
. 1994 Jul;84(7):1127–1131. doi: 10.2105/ajph.84.7.1127

Low birthweight at term and the timing of fetal exposure to maternal smoking.

E Lieberman 1, I Gremy 1, J M Lang 1, A P Cohen 1
PMCID: PMC1614741  PMID: 8017537

Abstract

OBJECTIVES. This study was undertaken to evaluate the risk of small-for-gestational-age birth for women who stop smoking or begin to smoke during pregnancy. METHODS. Women with term singleton pregnancies from a hospital-based cohort of 11,177 were classified as (1) nonsmokers; (2) smoked throughout pregnancy; (3) smoked during first trimester only; (4) smoked during first and second trimesters only; and (5) smoked during second and third trimesters or during third trimester only. Risk of small-for-gestational-age birth according to smoking category was estimated and adjusted for confounding factors by logistic regression. RESULTS. Women who stopped smoking by the third trimester were not at increased risk of small-for-gestational-age birth compared with nonsmokers. Women who began smoking during the second or third trimester had an elevated risk of small-for-gestational-age birth (odds ratio [OR] = 1.83; 95% confidence interval [CI] = 1.25, 2.67) similar to that for women who smoked throughout pregnancy (OR = 2.20; 95% CI = 1.90, 2.54). Risk of small-for-gestational-age birth increased with the number of cigarettes smoked during the third trimester. CONCLUSIONS. It is during the third trimester that smoking retards fetal growth, presenting a compelling opportunity for smoking cessation interventions. Programs must emphasize the importance of not resuming smoking late in pregnancy.

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Selected References

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  1. Butler N. R., Goldstein H., Ross E. M. Cigarette smoking in pregnancy: its influence on birth weight and perinatal mortality. Br Med J. 1972 Apr 15;2(5806):127–130. doi: 10.1136/bmj.2.5806.127. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Hebel J. R., Fox N. L., Sexton M. Dose-response of birth weight to various measures of maternal smoking during pregnancy. J Clin Epidemiol. 1988;41(5):483–489. doi: 10.1016/0895-4356(88)90050-9. [DOI] [PubMed] [Google Scholar]
  3. Kleinman J. C., Madans J. H. The effects of maternal smoking, physical stature, and educational attainment on the incidence of low birth weight. Am J Epidemiol. 1985 Jun;121(6):843–855. doi: 10.1093/oxfordjournals.aje.a114055. [DOI] [PubMed] [Google Scholar]
  4. Kleinman J. C., Pierre M. B., Jr, Madans J. H., Land G. H., Schramm W. F. The effects of maternal smoking on fetal and infant mortality. Am J Epidemiol. 1988 Feb;127(2):274–282. doi: 10.1093/oxfordjournals.aje.a114803. [DOI] [PubMed] [Google Scholar]
  5. Koops B. L., Morgan L. J., Battaglia F. C. Neonatal mortality risk in relation to birth weight and gestational age: update. J Pediatr. 1982 Dec;101(6):969–977. doi: 10.1016/s0022-3476(82)80024-3. [DOI] [PubMed] [Google Scholar]
  6. Kramer M. S. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ. 1987;65(5):663–737. [PMC free article] [PubMed] [Google Scholar]
  7. Lang J. M., Cohen A., Lieberman E. Risk factors for small-for-gestational-age birth in a preterm population. Am J Obstet Gynecol. 1992 May;166(5):1374–1378. doi: 10.1016/0002-9378(92)91607-c. [DOI] [PubMed] [Google Scholar]
  8. Lieberman E., Ryan K. J., Monson R. R., Schoenbaum S. C. Risk factors accounting for racial differences in the rate of premature birth. N Engl J Med. 1987 Sep 17;317(12):743–748. doi: 10.1056/NEJM198709173171206. [DOI] [PubMed] [Google Scholar]
  9. MacArthur C., Knox E. G. Smoking in pregnancy: effects of stopping at different stages. Br J Obstet Gynaecol. 1988 Jun;95(6):551–555. doi: 10.1111/j.1471-0528.1988.tb09481.x. [DOI] [PubMed] [Google Scholar]
  10. McDonald A. D., Armstrong B. G., Sloan M. Cigarette, alcohol, and coffee consumption and prematurity. Am J Public Health. 1992 Jan;82(1):87–90. doi: 10.2105/ajph.82.1.87. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Naeye R. L. Influence of maternal cigarette smoking during pregnancy on fetal and childhood growth. Obstet Gynecol. 1981 Jan;57(1):18–21. [PubMed] [Google Scholar]
  12. Robitaille Y., Kramer M. S. Does participation in prenatal courses lead to heavier babies? Am J Public Health. 1985 Oct;75(10):1186–1189. doi: 10.2105/ajph.75.10.1186. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Rush D., Cassano P. Relationship of cigarette smoking and social class to birth weight and perinatal mortality among all births in Britain, 5-11 April 1970. J Epidemiol Community Health. 1983 Dec;37(4):249–255. doi: 10.1136/jech.37.4.249. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Warshaw J. B. Intrauterine growth retardation. Pediatr Rev. 1986 Oct;8(4):107–114. doi: 10.1542/pir.8-4-107. [DOI] [PubMed] [Google Scholar]
  15. Williams M. A., Mittendorf R., Lieberman E., Monson R. R., Schoenbaum S. C., Genest D. R. Cigarette smoking during pregnancy in relation to placenta previa. Am J Obstet Gynecol. 1991 Jul;165(1):28–32. doi: 10.1016/0002-9378(91)90217-f. [DOI] [PubMed] [Google Scholar]
  16. Williams M. A., Mittendorf R., Stubblefield P. G., Lieberman E., Schoenbaum S. C., Monson R. R. Cigarettes, coffee, and preterm premature rupture of the membranes. Am J Epidemiol. 1992 Apr 15;135(8):895–903. doi: 10.1093/oxfordjournals.aje.a116385. [DOI] [PubMed] [Google Scholar]
  17. Williams R. L., Creasy R. K., Cunningham G. C., Hawes W. E., Norris F. D., Tashiro M. Fetal growth and perinatal viability in California. Obstet Gynecol. 1982 May;59(5):624–632. [PubMed] [Google Scholar]

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