Prenatal maternal smoking and offspring respiratory morbidity: Results of a population based cohort study

Tamar Wainstock, Asnat Walfisch, Eyal Sheiner

Research output: Contribution to journalMeeting Abstract


Maternal prenatal smoking is known to adversely affect pregnancy course and outcome. We aimed to evaluate the association between maternal prenatal smoking and the long-term risk for pediatric respiratory morbidity in the offspring, up to the age of 18 years.

Study Design
A population based cohort analysis was performed comparing the risk for long-term pediatric respiratory related hospitalizations, among children born to mothers who smoked during pregnancy versus those who did not. Pediatric respiratory related morbidities were pre-defined based on ICD-9 codes, as recorded in the hospital computerized medical files. Deliveries occurred between the years 1991-2014 at a regional tertiary medical center. Kaplan-Meier survival curves were used to compare cumulative respiratory related hospitalizations in both groups over time and Cox proportional hazards models were constructed to control for confounders.

During the study period 241,273 newborns met the inclusion criteria; 2841 of which were born to mothers who smoked during pregnancy. Offspring of smokers presented a significantly higher risk for total respiratory related hospitalizations (OR=1.70, 95% CI 1.48-1.95) including a higher cumulative incidence, as presented in the Kaplan-Meier survival curves (Figure, Log rank p<0.001). Selected respiratory related morbidities are presented in the table. In the Cox regression model, which controlled for maternal age, maternal diabetes, gestational age, and hypertensive disorders, smoking remained an independent risk factor for total pediatric respiratory related hospitalizations (adjusted HR 1.6; 95% CI 1.4-1.8).

Smoking during pregnancy, possibly an indicator of childhood exposure to smoking, is associated with an increased risk for childhood respiratory- related morbidities in the offspring.
Original languageEnglish GB
Pages (from-to)S438-S439
JournalAmerican Journal of Obstetrics and Gynecology
Issue number1
StatePublished - Jan 2018


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