Association Between Prenatal Exposure to Tobacco Smoke and Maternal and Neonatal Outcomes: A Retrospective Cohort Study

bateni, amin; Shamami, bafrin; Vazifehkhah, shabnam

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Volume 4, Issue 2 (Summer 2026)

Health Res Develop 2026, 4(2): 11-20

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Association Between Prenatal Exposure to Tobacco Smoke and Maternal and Neonatal Outcomes: A Retrospective Cohort Study

Amin Bateni¹

, Bafrin Shamami²

, Shabnam Vazifehkhah ^*³

1- & Assistant Professor of Community Medicine, Department of Community Medicine, Urmia University of Medical Sciences, Urmia, Iran, faculty of medicine
2- & Medical Student, Urmia University of Medical Sciences, Urmia, Iran, faculty of medicine
3- & Associate Professor of Perinatology, Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran, kowasar womens Hospital , Shabnam.vazifekhah@yahoo.com

Abstract: (186 Views)

Background: Exposure to tobacco smoke is recognized as a preventable risk factor for adverse pregnancy outcomes. This study was conducted to determine the association between exposure to cigarette smoke in pregnant women and neonatal physical indices as well as maternal outcomes at Motahari Hospital in Urmia.
Methods: This retrospective cohort study at Motahari Hospital, Urmia, included pregnant women aged 20–35 with singleton pregnancies at 20–40 weeks gestation during early 2020. Tobacco smoke exposure was assessed via structured telephone interviews due to COVID-19 restrictions. Maternal and neonatal outcomes were extracted from medical records. Sample size (n≈600) was calculated for 99% power based on birth weight differences. Data were analyzed to examine associations between prenatal tobacco exposure and outcomes.
Results: Out of 600 pregnant women, 3/3% of pregnant women smoked and 51/3% were exposed to secondhand smoke. The mean age of the mothers was 28/37 ± 5/22 years. The mean gestational age was 38/17 weeks, which was significantly lower in women exposed to cigarette than women who were not exposed to cigarette (37/9 vs. 38/3.3 weeks with P=0/004). Mean neonatal indices in mothers exposed to cigarette were significantly lower than neonates of mothers who were not exposed to cigarette smoke (height: 48/7 vs. 49/5 cm with P <0/01 Weight: 2970/8 vs. 3317/1 g with P <0/001 Head circumference: 34/3 vs/34/5 with P = 0/02).
Conclusion: Exposure to environmental tobacco smoke during pregnancy is significantly associated with reduced physical growth indicators in newborns and increased maternal complications. Implementing educational programs aimed at preventing tobacco smoke exposure among pregnant women is essential.

Keywords: Smoking, Pregnancy Outcome, Neonatal Outcome, Maternal Exposure

Full-Text [PDF 492 kb] (18 Downloads)

Type of Study: Original | Subject: Special
Received: 2025/11/16 | Accepted: 2026/01/17 | Published: 2026/07/1

References

1. Khanal V, Budhathoki S, Nath M, Tamrakar D, Pokharel H, Shrestha A, et al. Knowledge, attitude and practice regarding environmental tobacco smoke among pregnant women of Sunsari. Kathmandu Uni Med J. 2018 Oct.-Dec;64(4):281-4.

2. Underner M, Pourrat O, Perriot J, Peiffer G, Jaafari N. Smoking cessation and pregnancy. Gynecology. 2017 Oct;45(10):552-557. [DOI:10.1016/j.gofs.2017.08.003] [PMID]

3. Pereira PPdS, Da Mata FA, Figueiredo ACG, de Andrade KRC, Pereira MG. Maternal active smoking during pregnancy and low birth weight in the Americas: a systematic review and meta-analysis. Nicotine Tob Res. 2017 May 1;19(5):497-505. [DOI:10.1093/ntr/ntw228] [PMID]

4. Chertok IRA, Haile ZT. Trends in modification of smoking behaviors among pregnant women in West Virginia. Matern Child Health J. 2017 May;21(5):974-981. [DOI:10.1007/s10995-017-2265-4] [PMID]

5. Barnett MJ, Fealy S, Wilson A. Barriers and enablers for smoking cessation amongst pregnant women: an umbrella review. Women. 2019;32(4):310-7. [DOI:10.1016/j.wombi.2018.10.007] [PMID]

6. Gould GS, Patten C, Glover M, Kira A, Jayasinghe H. Smoking in pregnancy among Indigenous women in high-income countries: a narrative review. Nicotine Tob Res. 2017;19(5):506-17. [DOI:10.1093/ntr/ntw288] [PMID] []

7. Lagadec N, Steinecker M, Kapassi A, Magnier AM, Chastang J, Robert S, et al. Factors influencing the quality of life of pregnant women: a systematic review. Pregnancy Childbirth. 2018;18(1):1-14. [DOI:10.1186/s12884-018-2087-4] [PMID] []

8. Orazine CI, Arias WA, Magee SR, King E. Non-smoking pregnant women and their fetuses are exposed to environmental tobacco smoke as a result of living in multiunit housing. J Expo Sci Environ Epidemiol. 2017;27(5):465-70. [DOI:10.1038/jes.2016.34] [PMID]

9. Li H, Hansen AR, McGalliard Z, Gover L, Yan F, Zhang J. Trends in smoking and smoking cessation during pregnancy from 1985 to 2014, racial and ethnic disparity observed from multiple national surveys. Matern Child Health J. 2018;22(5):685-93. [DOI:10.1007/s10995-018-2437-x] [PMID]

10. Mitra M, Lu E, Diop H. Smoking among pregnant women with disabilities. J Expo Sci Environ Epidemiol. 2012;22(2): 233-9. [DOI:10.1016/j.whi.2011.11.003] [PMID]

11. Arbuckle TE, Liang CL, Fisher M, Caron NJ, Fraser WD. Exposure to tobacco smoke and validation of smoking status during pregnancy in the MIREC study. J Expo Sci Environ Epidemiol. 2018; 28(5): 461-9. [DOI:10.1038/s41370-017-0011-z] [PMID] []

12. Shakibazadeh E , Ahmadnia H . The Relationship Between Maternal Passive Smoking and Birth Weight and Height of Newborns. Journal of Advances in Medical and Biomedical 2004;11(45):37-40. [in Persian]

13. Ghotbi N, Zokai M, Rahmani K, Zand Vakili F, Zandi S, et al. Risk Factors Related to the Neonatal Mortality in Kurdistan Province, Iran: A Population-Based Case-Control Study.Shiraz E-Med J.2017;18(3):e44155. [DOI:10.5812/semj.44155]

14. Kim MK, Han K, You SY, Kwon HS, Yoon KH, Lee SH. Prepregnancy smoking and the risk of gestational diabetes requiring insulin therapy. Sci Rep. 2020 ;10(1):13901. https://doi.org/10.1038/s41598-019-50406-7 [DOI:10.1038/s41598-020-70873-7]

15. Feferkorn I, Badeghiesh A, Baghlaf H, Dahan MH. The relationship of smoking with gestational diabetes: a large population-based study and a matched comparison. Reprod Biomed Online. 2023;46(2):338-345. [DOI:10.1016/j.rbmo.2022.11.005] [PMID]

16. 16.Pintican D, Poienar AA, Strilciuc S, Mihu D. Effects of maternal smoking on human placental vascularization: A systematic review. Taiwan J Obstet Gynecol. 2019;58(4):454-459. [DOI:10.1016/j.tjog.2019.05.004] [PMID]

17. Martini DE, Rini EJS, Kusbiantoro D, susanti I. The Correlation Between Exposure to Cigarette Smoke and The Incidence of Anemia during Pregnancy. Surya J. Med Kom Ilm Kes. 2023 15(3):106-13. [DOI:10.38040/js.v15i3.840]

18. Margawati A, Syauqy A, Utami A, Adespin DA. Prevalence of Anemia and Associated Risk Factors among Pregnant Women in Semarang, Indonesia, during COVID-19 Pandemic. Ethiop J Health Sci. 2023;33(3):451-462. [DOI:10.4314/ejhs.v33i3.8] [PMID] []

19. Garrison-Desany HM, Ladd-Acosta C, Hong X, Wang G, Burd I, Sanchez ZVM, Wang X, Surkan PJ. Addressing the smoking-hypertension paradox in pregnancy: insight from a multiethnic US birth cohort. Precis Nutr. 2023;2(2):e00035.

20. Feferkorn I, Badeghiesh A, Baghlaf H, Dahan MH. The relation between cigarette smoking with delivery outcomes. An evaluation of a database of more than nine million deliveries. J Perinat Med. 2021;50(1):56-62. [DOI:10.1515/jpm-2021-0053] [PMID]

21. Liu B, Xu G, Sun Y, Qiu X, Ryckman KK, Yu Y, Snetselaar LG, Bao W. Maternal cigarette smoking before and during pregnancy and the risk of preterm birth: A dose-response analysis of 25 million mother-infant pairs. PLoS Med. 2020;17(8):e1003158 [DOI:10.1371/journal.pmed.1003158] [PMID] []

22. Abbasi-Kangevari M, Ghanbari A, Fattahi N, Malekpour MR, Masinaei M, Ahmadi N, et al. Tobacco consumption patterns among Iranian adults: a national and sub-national update from the STEPS survey 2021. Sci Rep. 2023;13(1):10272. [DOI:10.1038/s41598-023-37299-3] [PMID] []

23. Tarasi B, Cornuz J, Clair C, Baud D. Cigarette smoking during pregnancy and adverse perinatal outcomes: a cross-sectional study over 10 years. BMC Public Health. 2022;22(1):2403. [DOI:10.1186/s12889-022-14881-4] [PMID] []

24. Talebi M, Vakili V, Abbasi Shaye Z, Velayati M. Smoking during Pregnancy and Maternal and Neonatal Complications in Mashhad, Suburbs, and Subsidiary Villages: A Population-based Cross-Sectional Study. Iranian Journal of Neonatology, 2020; 11(4): 99-105.

25. Valizadeh A, Akbarian-rad Z, Qalehsari MQ, Zabihi A, Jafarian-amiri SR, Aziznejadroshan P, Akrami R. Exposure to Secondhand Smoke during Pregnancy and Neonatal-Related Outcomes. Iranian Journal of Neonatology. 2024;15(1).

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bateni A, Shamami B, Vazifehkhah S. (2026). Association Between Prenatal Exposure to Tobacco Smoke and Maternal and Neonatal Outcomes: A Retrospective Cohort Study. Health Res Develop. 4(2), 11-20.
URL: http://jhrd.trjums.ac.ir/article-1-150-en.html

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