AKU Student
no
Document Type
Article
DOI
10.71071/JAM/v12i2.1.14b
Abstract
Background: Low-birth weight (LBW; < 2.5 kg) infants are at increased risk of early mortality, impaired growth, neuro-developmental delay and chronic disease later in life. Maternal behavior, especially cigarette smoking, remains one of the most modifiable determinants of birth weight. We therefore synthesized recent evidence on the association between active maternal smoking during pregnancy and LBW.
Methods: Following PRISMA guidance, we systematically searched PubMed, Scopus and ScienceDirect for the period January 2020 to 31 January 2025 for English-language observational studies that quantified the relationship between active prenatal smoking and LBW. Risk of bias was appraised, and findings were summarized narratively.
Results: In total 26,650 papers were found and eight eligible studies (four cohort, three cross-sectional, one case-control) from Asia, Europe and the Middle East were included. Across all designs and exposure metrics—self-report, exhaled carbon-monoxide, urinary cotinine, and cord-blood DNA-methylation, active smoking was consistently associated with a 1.5- to 4-fold increase in odds of LBW compared with non-smoking. A clear dose-response pattern was observed: heavier daily consumption or persistence of smoking into the third trimester markedly amplified risk. Socio-economic disadvantage and elevated maternal stress clustered with smoking and further worsened outcomes.
Conclusions: Active maternal smoking is a dose-dependent driver of LBW and intersects with social disadvantage. Integrating smoking-cessation counselling and biomarker-based exposure screening into routine antenatal care, especially for women of lower socio-economic status, could substantially improve perinatal outcomes.
Recommended Citation
Sondang, N, Oktavia, N, Adnani, Q E, Gumilang, L, Susiarno, H, & Adepoju, V A. A scoping review of maternal active smoking during pregnancy and low-birth weight. Journal of Asian Midwives. 2025;12(2):40–51.
