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The effects of maternal smoking in pregnancy.


 A review of the extensive literature on the effects of smoking in pregnancy reveals that smoking causes significant reductions in birthweight, increases in premature births, increases in fetal and neonatal loss, and possible long-term disabilities in height, reading ability, and social adjustment. The association for the physical effects is dose-related. The effect of maternal smoking on perinatal mortality is positive and proportional to the level of smoking but varies according to other characteristics of the pregnancy. Studies indicate that this increased perinatal mortality is not due to aspects of the fetus but to smoking-related pregnancy complications. The immediate cause of most smoking-related fetal deaths is probably anoxia; the cause of neonatal mortality results from the increased risk of early delivery to smokers. It is recommended that the risks associated with smoking in pregnancy be widely publicized. Patients, especially those with high risk factors, should be advised against continued smoking during pregnancy.
