A new analysis has found that smoking even one or two cigarettes a day, either before or during pregnancy, can significantly harm newborns. The study, published in the Journal of Epidemiology & Community Health, examined data from over 12 million families and underscores that no amount of smoking is safe for maternal and infant health.
Globally, about 1.7% of pregnant women smoke, with higher rates in Europe (8.1%) and the Americas (5.9%). Smoking during pregnancy is linked to a range of adverse outcomes for newborns, including preterm birth, low birth weight, restricted growth, and increased risk of infant mortality.
The study focused on major neonatal health complications, such as the need for assisted ventilation immediately after birth, admission to the neonatal intensive care unit (NICU), suspected sepsis, seizures, and neurological issues. Researchers found that approximately 9.5% of babies experienced these complications. However, the likelihood of these issues increased by 27% if the mother smoked before pregnancy and by 31% if she smoked at any time during pregnancy.
“This study reinforces the notion that any level of smoking during pregnancy impacts infant health,” said Caitlin Notley, head of the addiction research group at the University of East Anglia, who was not involved in the study. “Even light smoking poses risks.”
The analysis included nearly 12.2 million mother-infant pairs in the United States, adjusting for factors such as age, ethnicity, and weight. Notably, women with high blood pressure or diabetes were excluded from the study.
Among the study participants, 9.3% smoked before pregnancy, 7% smoked during the first trimester, 6% during the second trimester, and 5.7% during the third trimester. The study found that neonatal outcomes worsened with continued smoking throughout pregnancy. Even women who ceased smoking during pregnancy still faced higher risks of poor outcomes compared to non-smokers.
Heavy smokers faced the greatest risks, with those smoking 20 or more cigarettes per day having a 29% higher likelihood of their child being admitted to intensive care. However, even those who smoked just one or two cigarettes a day saw a 13% increased risk of NICU admission.
“Cutting down on smoking is not sufficient,” emphasized Notley. “Complete cessation is essential to protect infant health.”
Pregnant women may struggle to quit smoking due to accelerated nicotine metabolism during pregnancy, which increases nicotine absorption. Notley suggests that women seeking to quit can use nicotine replacement therapies, such as nicotine gum, or consider switching from traditional cigarettes to e-cigarettes, though research on the impact of vaping during pregnancy is still inconclusive.
“It’s crucial to support pregnant women in quitting smoking through any available means,” Notley advised, emphasizing harm reduction strategies to improve both maternal and infant health.
