Background Maternal smoking during pregnancy may be associated with low birth weight(LBW)in offspring and global risk estimates have not been summarized previously.We aimed to systematically explore evidence regarding maternal smoking and the LBW risk in offspring globally and examine possible causes of heterogeneity across relevant studies.Methods Comprehensive search of PubMed,Ovid Embase,Ovid Medline(R),and Web of science from inception until October 2021 was carried out.A random-effects meta-analysis was used to estimate the pooled odds ratio(OR)and cor-responding 95％confidence interval(CI).Restricted cubic spline analysis with three knots was used to further examine the dose-response relationship.Results Literature searches yielded 4940 articles,of which 53 met inclusion criteria(comprising 55 independent stud-ies).Maternal smoking during pregnancy was significantly associated with the risk of LBW in offspring(OR=1.89,95％CI=1.80-1.98).Furthermore,an obvious dose-response relationship between the amount of cigarettes daily smoked in pregnancy and the risk of LBW in offspring was observed.The results of subgroup analyses indicated that the risk of mater-nal smoking on LBW was larger in more recently conducted studies(P=0.020)and longer period of active smoking during pregnancy(P=0.002).No evidence of publication bias was found.Conclusions In summary,maternal smoking in pregnancy was significantly associated with a higher risk of LBW in offspring on a global scale.The risk of maternal smoking on infant LBW seems to be increasing over time,and was higher with longer smoking duration throughout pregnancy and more cigarettes smoked daily.

Hong-Kun Di;Yong Gan;Kai Lu;Chao Wang;Yi Zhu;Xin Meng;Wen-Qi Xia;Min-Zhi Xu;Jing Feng;Qing-Feng Tian;Yan He;Zhi-Qiang Nie;Jun-An Liu;Fu-Jian Song;Zu-Xun Lu

Department of Social Medicine and Health Management,School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,No.13 Hangkong Road,Wuhan 430030,Hubei,China;Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei,China;School of Public Health,Zhengzhou University,Zhengzhou,Henan,China;Norwich Medical School,Faculty of Medicine and Health Science,University of East Anglia,Norwich NR47TJ,UK

世界儿科杂志（英文版）

[1]Hong-Kun Di;Yong Gan;Kai Lu;Chao Wang;Yi Zhu;Xin Meng;Wen-Qi Xia;Min-Zhi Xu;Jing Feng;Qing-Feng Tian;Yan He;Zhi-Qiang Nie;Jun-An Liu;Fu-Jian Song;Zu-Xun Lu-.Maternal smoking status during pregnancy and low birth weight in offspring:systematic review and meta-analysis of 55 cohort studies published from 1986 to 2020)[J].世界儿科杂志（英文版）,2022(03):176-185

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