Association between prenatal environmental tobacco smoke exposure and preterm birth: A systematic review and meta‐analysis

Abstract Introduction The purpose of this systematic review and meta‐analysis is to evaluate the global risk of preterm birth associated with passive smoking. Specifically, the study aims to examine whether passive smoking continues to impact preterm birth rates, with particular attention to the pot...

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Main Authors: Tong‐tong Fu, Han‐xiao Luo, Zhi‐jing Na, Chun‐ling Xia, Ling Fan
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.15126
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author Tong‐tong Fu
Han‐xiao Luo
Zhi‐jing Na
Chun‐ling Xia
Ling Fan
author_facet Tong‐tong Fu
Han‐xiao Luo
Zhi‐jing Na
Chun‐ling Xia
Ling Fan
author_sort Tong‐tong Fu
collection DOAJ
description Abstract Introduction The purpose of this systematic review and meta‐analysis is to evaluate the global risk of preterm birth associated with passive smoking. Specifically, the study aims to examine whether passive smoking continues to impact preterm birth rates, with particular attention to the potential effects following the implementation of stricter smoking bans in recent years. Material and Methods This systematic review and meta‐analysis followed PRISMA guidelines and was preregistered in PROSPERO. A comprehensive literature search was conducted in PubMed, Embase, CINAHL, and Web of Science up to February 17, 2024, using keywords related to passive smoking and preterm birth. Eligible observational studies were selected, and data were independently extracted and assessed for quality by two authors. Statistical analysis used odds ratios (ORs) and the I2 statistic for heterogeneity. Subgroup analyses and publication bias assessments were conducted. Review Manager and Stata were used for the analysis, with significance set at p < 0.05. Results Meta‐analysis showed a 21% increase in the odds of preterm birth in women exposed to environmental tobacco smoke (ETS) (OR, 1.21; 95% CI, 1.10–1.32) with significant heterogeneity (I2 = 76.2%). Stronger associations were found in cohort and cross‐sectional studies, studies in Asia, larger sample sizes, and recent publications. Findings were robust across various analyses. Conclusions Prenatal environmental tobacco smoke exposure significantly increases preterm birth risk. Effective public health interventions, including stringent smoke‐free policies, public education, and awareness campaigns, are needed to reduce environmental tobacco smoke exposure and improve maternal and infant health outcomes.
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spelling doaj-art-4321e8ffd09f41dca9a8c66e230bf8602025-08-20T02:09:25ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122025-07-0110471244125310.1111/aogs.15126Association between prenatal environmental tobacco smoke exposure and preterm birth: A systematic review and meta‐analysisTong‐tong Fu0Han‐xiao Luo1Zhi‐jing Na2Chun‐ling Xia3Ling Fan4Department of Nursing Shengjing Hospital of China Medical University Shenyang Liaoning ChinaDepartment of Nursing Shengjing Hospital of China Medical University Shenyang Liaoning ChinaCenter of Reproductive Medicine, Department of Obstetrics and Gynecology Shengjing Hospital of China Medical University Shenyang Liaoning ChinaDepartment of Obstetrics and Gynecology Shengjing Hospital of China Medical University Shenyang Liaoning ChinaDepartment of Nursing Shengjing Hospital of China Medical University Shenyang Liaoning ChinaAbstract Introduction The purpose of this systematic review and meta‐analysis is to evaluate the global risk of preterm birth associated with passive smoking. Specifically, the study aims to examine whether passive smoking continues to impact preterm birth rates, with particular attention to the potential effects following the implementation of stricter smoking bans in recent years. Material and Methods This systematic review and meta‐analysis followed PRISMA guidelines and was preregistered in PROSPERO. A comprehensive literature search was conducted in PubMed, Embase, CINAHL, and Web of Science up to February 17, 2024, using keywords related to passive smoking and preterm birth. Eligible observational studies were selected, and data were independently extracted and assessed for quality by two authors. Statistical analysis used odds ratios (ORs) and the I2 statistic for heterogeneity. Subgroup analyses and publication bias assessments were conducted. Review Manager and Stata were used for the analysis, with significance set at p < 0.05. Results Meta‐analysis showed a 21% increase in the odds of preterm birth in women exposed to environmental tobacco smoke (ETS) (OR, 1.21; 95% CI, 1.10–1.32) with significant heterogeneity (I2 = 76.2%). Stronger associations were found in cohort and cross‐sectional studies, studies in Asia, larger sample sizes, and recent publications. Findings were robust across various analyses. Conclusions Prenatal environmental tobacco smoke exposure significantly increases preterm birth risk. Effective public health interventions, including stringent smoke‐free policies, public education, and awareness campaigns, are needed to reduce environmental tobacco smoke exposure and improve maternal and infant health outcomes.https://doi.org/10.1111/aogs.15126anti‐smoking policymeta‐analysisprenatal environmental tobacco smoke exposurepreterm birth
spellingShingle Tong‐tong Fu
Han‐xiao Luo
Zhi‐jing Na
Chun‐ling Xia
Ling Fan
Association between prenatal environmental tobacco smoke exposure and preterm birth: A systematic review and meta‐analysis
Acta Obstetricia et Gynecologica Scandinavica
anti‐smoking policy
meta‐analysis
prenatal environmental tobacco smoke exposure
preterm birth
title Association between prenatal environmental tobacco smoke exposure and preterm birth: A systematic review and meta‐analysis
title_full Association between prenatal environmental tobacco smoke exposure and preterm birth: A systematic review and meta‐analysis
title_fullStr Association between prenatal environmental tobacco smoke exposure and preterm birth: A systematic review and meta‐analysis
title_full_unstemmed Association between prenatal environmental tobacco smoke exposure and preterm birth: A systematic review and meta‐analysis
title_short Association between prenatal environmental tobacco smoke exposure and preterm birth: A systematic review and meta‐analysis
title_sort association between prenatal environmental tobacco smoke exposure and preterm birth a systematic review and meta analysis
topic anti‐smoking policy
meta‐analysis
prenatal environmental tobacco smoke exposure
preterm birth
url https://doi.org/10.1111/aogs.15126
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