ReviewGynecologic and obstetric investigation2009
Combined effects of cigarette smoking and alcohol consumption on perinatal outcome.
Review in Gynecologic and obstetric investigation, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 3 syntheses or guidelines pooled it, 103 citations in OpenAlex.
- The effects of prenatal psychosocial work stress on adverse pregnancy outcomes: A comprehensive systematic review and meta-analysis.Scandinavian journal of work, environment & health · 2025Pooled it
- Parental conditions, modifiable lifestyle factors, and first trimester growth and development: a systematic review.Human reproduction update · 2025Pooled it
- Dose-response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age (SGA)-a systematic review and meta-analyses.BJOG : an international journal of obstetrics and gynaecology · 2011Pooled it
- Preventing Alcohol and Tobacco Exposed Pregnancies: CHOICES Plus in Primary Care.American journal of preventive medicine · 2017Trial
- Nicotine metabolites generate craniofacial defects that are worsened by ethanol exposure.PNAS nexus · 2026Article
- Substance use patterns among individuals who consume alcohol during pregnancy: Results from a US multi-site study.Drug and alcohol dependence · 2026Article
- A register-based study of long-term health and social care costs among children with prenatal alcohol exposure.PloS one · 2026Article
- Unraveling the complexity of selected adverse neonatal outcomes in India: a multilevel analysis using data from a nationally representative sample survey.BMC pregnancy and childbirth · 2025Article
- In Utero Alcohol and Tobacco Exposure, Maternal Depression, And Maternal Obesity Are Associated with Impaired Oligodendrocyte Differentiation in The Developing Brain.Obstetrics and gynecology research · 2025Article
- Selecting a birth weight standard for an indigenous population in a LMIC: A prospective comparative study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2024Article
- Editorial: Maternal substance and alcohol use and contextual issues.Frontiers in psychiatry · 2024Article
- Maternal and paternal risk factors for fetal alcohol spectrum disorders: Alcohol and other drug use as proximal influences.Alcohol, clinical & experimental research · 2023Article
- Associations between prenatal alcohol and tobacco exposure on Doppler flow velocity waveforms in pregnancy: a South African study.BMC pregnancy and childbirth · 2023Article
- Folic acid supplements and perinatal mortality in China.Frontiers in nutrition · 2023Article
- Maternal factors and child health conditions at birth associated with preterm deaths in a tertiary health facility in Ghana: A retrospective analysis.Frontiers in public health · 2023Article
- Alcohol consumption and tobacco exposure among pregnant women in Ibadan, Nigeria.BMC psychiatry · 2022Article
- The tragedy of smoking, alcohol, and multiple substance use during pregnancy.South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde · 2022Article
- Alcohol's Impact on the Fetus.Nutrients · 2021Review
- Association of Prenatal Exposure to Maternal Drinking and Smoking With the Risk of Stillbirth.JAMA network open · 2021Article
- Association of Concomitant Drinking and Smoking during Pregnancy with Placental Abruption, Fetal Growth Restriction and Sudden Infant Death Syndrome (SIDS).Journal of Pulmonary Medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundAn increase in various congenital abnormalities associated with cigarette smoking and the use of alcohol during pregnancy has been reported in many studies. These exposures also increase the risk of pregnancy complications such as abruptio placentae, unexplained stillbirth, preterm labor and intrauterine growth restriction. However, very few studies have addressed the combined effect of smoking and drinking on pregnancy outcomes.
methodsIn this review, the adverse effects of smoking or drinking on pregnancy were obtained from publications in which both substances were addressed in the same study population. A special effort was made to find studies in which the combined effect of these substances was investigated.
resultsPreterm labor occurred more frequently in women who drank and smoked during pregnancy. This increased odds ratio was more than the sum of the effects of either smoking or drinking, indicating that the use of both substances by the same woman has a synergistic effect that increases the risk of preterm labor. This synergistic effect was also found for low birth weight and growth restriction.
conclusionsAs most of the women who drink during pregnancy also smoke cigarettes, attention should be given to the prevention or reduced use of both substances during pregnancy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.