European Journal of Pediatrics

, Volume 169, Issue 6, pp 741–748 | Cite as

Smoking and smoking cessation during early pregnancy and its effect on adverse pregnancy outcomes and fetal growth

  • Constantine I. Vardavas
  • Leda Chatzi
  • Evridiki Patelarou
  • Estel Plana
  • Katerina Sarri
  • Anthony Kafatos
  • Antonis D. Koutis
  • Manolis Kogevinas
Original Paper


Maternal smoking during pregnancy is a significant threat to the fetus. We examined the association between active maternal smoking and smoking cessation during early pregnancy with newborn somatometrics and adverse pregnancy outcomes including preterm delivery, low birth weight, and fetal growth restriction. One thousand four hundred mother–child pairs with extensive questionnaire data were followed up until delivery, within the context of a population-based mother–child cohort study (Rhea study), in Crete, Greece, 2007–2008. Comparing smokers to nonsmokers, the adjusted odds ratio (OR) was 2.8 [95% confidence interval (CI), 1.7, 4.6] for low birth weight and 2.6 (95%CI: 1.6, 4.2) for fetal growth restriction. This corresponded to a 119-g reduction in birth weight, a 0.53-cm reduction in length, and a 0.35-cm reduction in head circumference. Smoking cessation early during pregnancy modified significantly these pregnancy outcomes indicating the necessity for primary smoking prevention.


Pregnancy Fetal growth Smoking Cessation Small for gestational age Smoking cessation Preterm delivery Prevention 



C.I. Vardavas and E. Patelarou are supported by a Flight Attendant Medical Research Institute (FAMRI) grant (Clinical Investigator Award 072058). This work was partly supported by the EU Integrated Project NewGeneris, 6th Framework Programme (contract no. FOOD-CT-2005-016320) and by the EU funded project HiWATE, 6th Framework Programme (contract no. Food-CT-2006-036224).

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Constantine I. Vardavas
    • 1
  • Leda Chatzi
    • 1
  • Evridiki Patelarou
    • 1
  • Estel Plana
    • 2
  • Katerina Sarri
    • 1
  • Anthony Kafatos
    • 1
  • Antonis D. Koutis
    • 1
  • Manolis Kogevinas
    • 1
    • 2
    • 3
    • 4
  1. 1.Department of Social MedicineUniversity of CreteHeraklionGreece
  2. 2.Center for Research in Environmental Epidemiology (CREAL)BarcelonaSpain
  3. 3.Municipal Institute of Medical Research (IMIM-Hospital del Mar)BarcelonaSpain
  4. 4.CIBER Epidemiologia y Salud Pública (CIBERESP)BarcelonaSpain

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