Review

International Journal of Obesity (2008) 32, 201–210; doi:10.1038/sj.ijo.0803760; published online 27 November 2007

Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis

E Oken1, E B Levitan2 and M W Gillman1,3

  1. 1Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA, USA
  2. 2Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA
  3. 3Department of Nutrition, Harvard School of Public Health, Boston, MA, USA

Correspondence: Dr E Oken, Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Avenue, 6th Floor, Boston, MA 02215, USA. E-mail: emily_oken@hphc.org

Received 29 June 2007; Revised 20 September 2007; Accepted 14 October 2007; Published online 27 November 2007.

Top

Abstract

Objective:

 

Perform a systematic review of studies reporting on the association between maternal prenatal cigarette smoking and child overweight.

Design:

 

Meta-analysis of observational studies.

Data sources:

 

Medline search and review of reference lists among studies published through June 2006.

Review methods:

 

Included studies reported an association between maternal smoking during pregnancy and risk of overweight among children at least 2 years of age. We did not include in the meta-analysis studies that provided only a continuous measure of adiposity, although those studies are discussed separately.

Results:

 

Based on results of 84 563 children reported in 14 observational studies, children whose mothers smoked during pregnancy were at elevated risk for overweight (pooled adjusted odds ratio (OR) 1.50, 95% CI: 1.36, 1.65) at ages 3–33 years, compared with children whose mothers did not smoke during pregnancy. The pooled estimate from unadjusted odds ratios (OR 1.52, 95% CI: 1.36, 1.69) was similar to the adjusted estimate, suggesting that sociodemographic and behavioral differences between smokers and nonsmokers did not explain the observed association. Although we observed evidence for publication bias, simulating a symmetric set of studies yielded a similar estimate (OR 1.40, 95% CI: 1.26, 1.55).

Conclusions:

 

Prenatal smoking exposure appears to increase rates of overweight in childhood. In parts of the world undergoing the epidemiologic transition, the continuing increase in smoking among young women could contribute to spiraling increases in rates of obesity-related health outcomes in the 21st century.

Keywords:

smoking, pregnancy, overweight, meta-analysis, systematic review

Extra navigation

.

naturejobs

More science jobs
Post a job for free
ADVERTISEMENT