Association between active tobacco use during pregnancy and infant respiratory health: a systematic review and meta-analysis
Objective To evaluate what is known about active tobacco use during pregnancy and the association with infant respiratory health.Design Systematic review and meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sources MEDLINE, EMBASE, Cochrane,...
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e037819.full |
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| author | Billie Bonevski Gillian Sandra Gould Joerg Mattes Vanessa E Murphy Ediane de Queiroz Andrade Carla Rebeca Da Silva Sena Adam Collison |
| author_facet | Billie Bonevski Gillian Sandra Gould Joerg Mattes Vanessa E Murphy Ediane de Queiroz Andrade Carla Rebeca Da Silva Sena Adam Collison |
| author_sort | Billie Bonevski |
| collection | DOAJ |
| description | Objective To evaluate what is known about active tobacco use during pregnancy and the association with infant respiratory health.Design Systematic review and meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sources MEDLINE, EMBASE, Cochrane, CINAHL, and Maternity and Infant Care were searched thoroughly until June 2020.Eligibility criteria for selecting studies We included case–control and cohort studies estimating the association between active tobacco use during pregnancy and infant respiratory health (wheezing and apnoea) and lung function parameters in the first 12 months of life.Data extraction and synthesis Extraction and risk of bias assessment were conducted by two independent reviewers. The odds ratio, relative risk and mean differences were pooled with a 95% CI using the generic inverse variance method. Heterogeneity was assessed and expressed by percentage using I2.Results We identified 4423 abstracts, and 21 publications met the eligibility criteria. Pooled OR showed an increase in wheezing episodes in infants born to mothers who were active tobacco users during pregnancy (OR 1.50, 95% CI 1.27 to 1.77, p<0.01). Mixed results were found on lung function parameters, and a meta-analysis including two studies with comparable methodology showed a trend towards reduced maximum flow rate at functional residual capacity of −34.59 mL/s (95% CI −72.81 to 3.63, p=0.08) in 1-month-old infants born to women who smoked during pregnancy. A higher risk of apnoea was described for infants born to mothers who used smokeless tobacco during pregnancy, while the results in infants born to women who actively smoked tobacco during pregnancy were non-conclusive.Conclusion Infants born to mothers who actively smoked during pregnancy are at higher odds of having wheeze and may have lower lung function. Smokeless tobacco use in pregnancy may increase the risk of apnoea in infancy.PROSPERO registration number CRD42018083936. |
| format | Article |
| id | doaj-art-5472d0fc835844b0aa5c94b99689b02b |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-5472d0fc835844b0aa5c94b99689b02b2025-01-07T14:30:09ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-037819Association between active tobacco use during pregnancy and infant respiratory health: a systematic review and meta-analysisBillie Bonevski0Gillian Sandra Gould1Joerg Mattes2Vanessa E Murphy3Ediane de Queiroz Andrade4Carla Rebeca Da Silva Sena5Adam Collison61 Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, AustraliaFaculty of Health, Southern Cross University, Lismore, New South Wales, AustraliaDepartment of Paediatric Respiratory & Sleep Medicine, John Hunter Children’s Hospital, Newcastle, New South Wales, AustraliaSchool of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, AustraliaGrowUpWell Priority Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, AustraliaPriority Research Centre GrowUpWell, The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, AustraliaGrowUpWell Priority Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, AustraliaObjective To evaluate what is known about active tobacco use during pregnancy and the association with infant respiratory health.Design Systematic review and meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sources MEDLINE, EMBASE, Cochrane, CINAHL, and Maternity and Infant Care were searched thoroughly until June 2020.Eligibility criteria for selecting studies We included case–control and cohort studies estimating the association between active tobacco use during pregnancy and infant respiratory health (wheezing and apnoea) and lung function parameters in the first 12 months of life.Data extraction and synthesis Extraction and risk of bias assessment were conducted by two independent reviewers. The odds ratio, relative risk and mean differences were pooled with a 95% CI using the generic inverse variance method. Heterogeneity was assessed and expressed by percentage using I2.Results We identified 4423 abstracts, and 21 publications met the eligibility criteria. Pooled OR showed an increase in wheezing episodes in infants born to mothers who were active tobacco users during pregnancy (OR 1.50, 95% CI 1.27 to 1.77, p<0.01). Mixed results were found on lung function parameters, and a meta-analysis including two studies with comparable methodology showed a trend towards reduced maximum flow rate at functional residual capacity of −34.59 mL/s (95% CI −72.81 to 3.63, p=0.08) in 1-month-old infants born to women who smoked during pregnancy. A higher risk of apnoea was described for infants born to mothers who used smokeless tobacco during pregnancy, while the results in infants born to women who actively smoked tobacco during pregnancy were non-conclusive.Conclusion Infants born to mothers who actively smoked during pregnancy are at higher odds of having wheeze and may have lower lung function. Smokeless tobacco use in pregnancy may increase the risk of apnoea in infancy.PROSPERO registration number CRD42018083936.https://bmjopen.bmj.com/content/10/9/e037819.full |
| spellingShingle | Billie Bonevski Gillian Sandra Gould Joerg Mattes Vanessa E Murphy Ediane de Queiroz Andrade Carla Rebeca Da Silva Sena Adam Collison Association between active tobacco use during pregnancy and infant respiratory health: a systematic review and meta-analysis BMJ Open |
| title | Association between active tobacco use during pregnancy and infant respiratory health: a systematic review and meta-analysis |
| title_full | Association between active tobacco use during pregnancy and infant respiratory health: a systematic review and meta-analysis |
| title_fullStr | Association between active tobacco use during pregnancy and infant respiratory health: a systematic review and meta-analysis |
| title_full_unstemmed | Association between active tobacco use during pregnancy and infant respiratory health: a systematic review and meta-analysis |
| title_short | Association between active tobacco use during pregnancy and infant respiratory health: a systematic review and meta-analysis |
| title_sort | association between active tobacco use during pregnancy and infant respiratory health a systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/10/9/e037819.full |
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