Smoking in Pregnancy: An Ongoing Challenge

Maternal smoking during pregnancy carries significant risks to mother infant and child. Smoking during pregnancy is associated with an increased risk of ectopic pregnancy, placental previa and abruption, preterm premature rupture of membranes, fetal growth restriction, preterm delivery, oral facial clefts, and sudden infant death syndrome.1,2 One of the most measurable effects of smoking is approximately doubling the risk of delivering a low birth weight infant.2 This special issue of the journal highlights the continued risks of smoking in pregnancy and the importance of policies and interventions to address this issue, despite the progress that has been made in reducing smoking in pregnancy in some countries. New data on risks, incidence, interventions and women’s own perspectives are highlighted. Together the included papers provide new data examining key issues in the field, from a wide range of countries. On risks, two papers are included. Although most of the research examining the effects of smoking on birth weight has been conducted in high income countries, a meta-analysis in this review confirms the association between smoking during pregnancy and low birth weight in the Americas.3 Additionally, although studies suggest a causal inference between maternal smoking and disruptive behavioral disorders and attention deficit disorder in children,2 this edition provides new data on the potential risk of maternal smoking and a broad range of psychiatric morbidity in the offspring using sibling pairs that controls for genetic and familial factors.4