Smoking during Pregnancy and Adverse Birth and Maternal Outcomes in California, 2007 to 2016

Anura W.G. Ratnasiri, Lauren Gordon, Ronald A. Dieckmann, Henry C. Lee, Steven S. Parry, Vivi N. Arief, Ian H. Delacy, Satyan Lakshminrusimha, Ralph J. Dilibero, Kaye E. Basford

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Objective â This study aimed to determine associations between maternal cigarette smoking andadverse birth and maternal outcomes. Study Design This is a 10-year population-based retrospective cohort study including 4,971,896 resident births in California. Pregnancy outcomes of maternal smokers were compared with those of nonsmokers. The outcomes of women who stopped smoking before or during various stages of pregnancy were also investigated. Results Infants of women who smoked during pregnancy were twice as likely to have low birth weight (LBW) and be small for gestational age (SGA), 57 more likely to have very LBW (VLBW) or be a preterm birth (PTB), and 59% more likely to have a very PTB compared with infants of nonsmokers. During the study period, a significant widening of gaps developed in both rates of LBW and PTB and the percentage of SGA between infants of maternal smokers and nonsmokers. Conclusion Smoking during pregnancy is associated with a significantly increased risk of adverse birth and maternal outcomes, and differences in rates of LBW, PTB, and SGA between infants of maternal smokers and nonsmokers increased during this period. Stopping smoking before pregnancy or even during the first trimester significantly decreased the infant risks of LBW, PTB, SGA, and the maternal risk for cesarean delivery.

Original languageEnglish (US)
Pages (from-to)1364-1376
Number of pages13
JournalAmerican journal of perinatology
Issue number13
StatePublished - Nov 1 2020


  • cesarean delivery
  • intrauterine growth restriction
  • low birth weight
  • preterm birth
  • small for gestational age
  • smoking during pregnancy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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