A case-control study of maternal smoking and congenital malformations

Paediatr Perinat Epidemiol. 1990 Apr;4(2):147-55. doi: 10.1111/j.1365-3016.1990.tb00630.x.


We conducted a population-based case-control study to assess the association between maternal smoking during pregnancy and the risk of giving birth to a child with a congenital malformation. Cases were all singleton livebirths with a congenital malformation recorded on the 1984-1986 Washington State Birth Records (n = 3284). The smoking histories of these mothers were compared to a randomly selected group of mothers with a singleton livebirth of a child without a malformation during these same years (n = 4500). When all malformations were taken as a group, there was no association with maternal smoking (relative risk (RR) = 1.0, 95% CI 0.9-1.1). However, increased risks were observed for a number of specific malformations, including microcephalus (RR = 2.0, 95% CI 1.0-4.0), cleft defects (RR = 1.4, 95% CI 1.0-2.0), and club foot (RR = 1.4, 95% CI 1.0-2.0). We did not find any association with Down's syndrome (RR = 0.8 95% CI 0.5-1.3) or any other malformation. We conclude that maternal smoking during pregnancy may be associated with an increased risk for some malformations.

MeSH terms

  • Age Factors
  • Case-Control Studies
  • Cleft Palate / etiology
  • Congenital Abnormalities / etiology*
  • Female
  • Humans
  • Infant, Newborn
  • Maternal Behavior
  • Microcephaly / etiology
  • Pregnancy*
  • Risk Factors
  • Smoking / adverse effects*
  • Washington