Smoking before or during early pregnancy negatively affects the baby
Substantial scientific literature supports the conclusion that maternal smoking before or during early pregnancy negatively affects the baby, leading to restricted fetal growth, epigenetic alterations, and long-term neurodevelopmental or behavioral issues.
The retrieved papers consistently show that prenatal tobacco exposure and maternal smoking negatively impact fetal health, birth outcomes, and offspring development. Multiple systematic reviews and cohort studies corroborate these findings with moderate-to-high certainty evidence, and no papers contradict this relationship.
Fraile-Martinez O, Rubio-Bedoya N, García-Montero C, Boaru DL, de Castro-Martinez P, Bujan J, López-González L, Díaz-Pedrero R, García-Honduvilla N, Álvarez-Mon M, Saez MA, De León-Luis JA, Bravo C, Ortega MA. Placental Pathophysiology in Maternal Psychoactive Substance Use: Biological, Clinical, and Forensic Perspectives.. 2026. https://doi.org/10.3390/cells15121128
Paper 1 notes that tobacco and other psychoactive substances cross the placental barrier, disrupting development and increasing risks like intrauterine growth restriction.
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Sharma RK, Kumari U. Environmental Exposure-Induced Epigenetic Modifications and Adverse Pregnancy Outcomes: A Systematic Review.. 2026. https://doi.org/10.7759/cureus.109320
Paper 2 demonstrates through a systematic review that prenatal tobacco smoke exposure leads to epigenetic modifications linked to adverse pregnancy outcomes such as low birth weight and preterm birth.
Ambildhok K, Asawa K. The Consequences of Prenatal Tobacco Exposure: A Systematic Review of Birth Outcomes and Developmental Trajectories.. 2026. https://doi.org/10.7759/cureus.105888
Paper 5 confirms via a systematic review that maternal smoking during pregnancy is consistently associated with reduced birth weight and adverse neurodevelopmental and psychiatric outcomes.
Martinez Mayans M, Gonçalves R, El Maroun H, Gaillard R, Jaddoe VWV. Maternal Early-Pregnancy Cardiovascular Health and Offspring Emotional, Behavioral, and Cognitive Outcomes in Adolescence.. 2026. https://doi.org/10.1161/jaha.125.045736
Paper 6 includes smoking as part of early-pregnancy cardiovascular health, noting that suboptimal status increases the risk of emotional, behavioral, and cognitive problems in offspring.
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