| Abstract
Purpose: The aim of this study was to investigate the effect of maternal smoking during pregnancy (MSDP) on the risk of bone fractures in offspring through a systematic review and meta-analysis.
Methods: Electronic databases including PubMed, Web of Science and Scopus were systematically searched for relevant articles published up to July 2019. According to heterogeneity the pooled risk ratio (RR) and odds ratio (OR) and their corresponding 95% confidence interval (95% CI) were obtained by fixed or random effect model. Heterogeneity and quality of included studies were assessed by I-squared (I2) statistic and Newcastle-Ottawa scale, respectively. Sensitivity analyses were performed to test the effect of MSDP misclassification on the results.
Results: After reviewing 842 search records, a total of 5 studies including 8746 mother-child pair were included in the meta-analysis. Pooling adjusted effect measures showed that MSDP was not associated with later risk of bone fractures in offspring (pooled RR=1.15, 95% CI: 0.84, 1.58, I2=66.8%, P=0.049). After adjusting for misclassification, MSDP may be associated with 27% increased risk of bone fracture (pooled OR=1.27, 95% CI: 1.00, 1.62, I2=0%, P=0.537).
Conclusion: After adjusting for misclassification, the MSDP is associated with the increase risk of bone fractures among children whose mother smoke during pregnancy. |