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Home What's New UK Chapter Review article by Dr Michelle Fernandes et all

Review article by Dr Michelle Fernandes et all

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Smoking during pregnancy and vision difficulties in children: a systematic review

Image result for dr micheel fernandesCover image for Vol. 93 Issue 2


Cigarette smoking during pregnancy is a major public health concern. Intra-uterine exposure to maternal cigarette smoking is associated with increased risks of growth and neurodevelopmental problems during childhood and later life. Few studies have focussed on visual difficulties in children in the context of maternal smoking during pregnancy. A systematic search of online databases was carried out between February and May 2013 to examine the trend in visual outcomes in children exposed to maternal cigarette smoking during intra-uterine life. Twenty-four non-randomized studies were identified. Each study was rated for quality using the Newcastle-Ottawa Scale. Most studies (n = 18) reported fetal exposure to active or passive maternal cigarette smoking to be associated with an increased risk of adverse visual outcomes in children. In particular, there were higher rates of strabismus, refractive errors and retinopathy among children of women who smoked during pregnancy. These findings suggest that fetal exposure to cigarette smoke is a significant risk factor for visual problems during later life and that certain visual faculties, such as the intraocular muscles and retinal neurons, are more affected than others. The findings provide evidence in support of public health policies aimed at reducing fetal exposure to smoking by advising both women and their partners to quit smoking during pregnancy.

We gratefully acknowledge the contributions of Emma Plugge at the Nuffield Department of Population Health and Karine Barker at the Radcliffe Science Library, University of Oxford. We are grateful to the Nuffield Department of Obstetrics and Gynaecology and the Li Ka Shing Foundation for supporting this work.

  1. Dr Michelle Fernandes had primary responsibility for research design, designing of the analytical framework of the study, database searching, evaluation of studies and performance of the final analysis, and in the writing of the manuscript. Dr Xiao Yang had primary responsibility for database searching, review of the papers, data collection and analysis, quality assessment and writing of the manuscript. Dr Jinying Li provided professional advice on the aspects of the study relating to paediatric ophthalmology. Dr Leila Cheikh Ismail supervised the design and execution of this work.

    There are no conflict of interests. Dr Yang is funded by the Li Ka Shing Scholarship from the Nuffield Department of Population Health, University of Oxford. Dr Fernandes and Dr. Cheikh Ismail are funded by the Bill and Melinda Gates Foundation via the INTERGROWTH-21st Project and the Nuffield Department of Obstetrics and Gynaecology, University of Oxford.



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