The Effect of Active Smoking of Pregnant Women on Premature Birth: A Meta Analysis

Imam Setya Arifian, Vitri Widyaningsih, Hanung Prasetya


Background: Smoking is a well-known major risk factor for premature death from cancer, cardiovascular disease, and chronic obstructive pulmonary disease. When a pregnant woman smokes, she puts herself and her baby at risk. This is because the developing fetus / baby in the mother's womb is in contact with the mother's bloodstream. Any chemical that the mother inhales or swallows can affect the fetus. This study aims to analyze the magnitude of the effect of active smoking on pregnant women with preterm labor by means of a meta-analysis study.

Subjects and Method: This was a systematic review and meta-analysis carried out by follow­ing the PRISMA flow diagram. The process of searching for articles is through a journal data­base which includes: PubMed, Springer Link, and Google Scholar by selecting articles published in 2005-2020. Keywords used include: "Maternal Smoking" OR "Smoking During Pregnancy" AND "Preterm Birth" OR "Premature" AND "multivariate" AND "AOR". The inclusion criteria were full paper articles with observational study design, articles in English, and multivariate analysis used with adjusted odds ratios. Articles that meet the requirements are analyzed using the Revmen 5.3 application.

Results: A total of 19 articles were reviewed in this study with a cross-sectional cohordant study design. A meta-analysis of 6 cohort studies showed that active smoking in pregnant women had a 1.34-fold increase in the incidence of pre­term birth compared with nonsmoking pregnant women (aOR= 1.34; 95% CI= 0.14 to 5.80; p= 0.002). A meta-analysis of 5 cross-sectional studies showed that active smoking in pregnant women had a 1.29-fold increase in the incidence of preterm birth compared with nonsmoking pregnant women (aOR= 1.29; 95% CI= 0.89 to 4.54; p= 0.04).

Conclusion: Active smoking in pregnant women increases preterm labor.

Keywords: pregnant women smoking, pre­mature labor, meta-analysis

Correspondence: Imam Setya Arifian. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Su­tami 36A, Surakarta 57126, Central Java. Email: Mobile: 08525­3402793.

Journal of Maternal and Child Health (2021), 06(01): 95-107

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