{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:41:38Z","timestamp":1788543698579,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,10,17]],"date-time":"2020-10-17T00:00:00Z","timestamp":1602892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","award":["2018JJ2551"],"award-info":[{"award-number":["2018JJ2551"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2021,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The present study aimed at providing some epidemiological evidences to assess the association of paternal smoking with the risk of neural tube defects (NTDs) and its specific subtypes in offspring, and explore the possible dose\u2013response relationship between paternal smoking and risk of NTDs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>English and Chinese databases were systematically searched from 1984 to May 2020. Either a fixed\u2010 or a random\u2010effects model was used to calculate the overall combined risk estimates. We also examined the dose\u2013response relationship between parental smoking and risk of NTDs in offspring. Subgroup analyses and sensitivity analyses were conducted to explore possible sources of heterogeneity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 10 case\u2013control studies involving 2,593 cases of NTDs and 45,100 controls were included for analysis. Findings from our study showed that paternal smoking was significantly associated with risk of total NTDs (odds ratio [OR] = 1.68; 95% confidence interval (CI): 1.48\u20131.92) and two subtypes including anencephaly (OR\u00a0=\u00a01.41; 95% CI: 1.06\u20131.86) and encephaloceles (OR\u00a0=\u00a02.90; 95% CI: 1.00\u20138.41). Additionally, a linear dose\u2013response relationship between paternal smoking and risk of NTDs was observed, which indicated that the risk of NTDs in offspring was significantly increased by 45% (OR\u00a0=\u00a01.45, 95% CI: 1.14\u20131.84) for each increment of half a pack of cigarettes per day. Sensitivity analyses yielded consistent results. No evidence of publication bias was found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Paternal smoking is significantly associated with the risk of NTDs in offspring. Therefore, it should be recommended that fathers quit smoking before pregnancy to prevent NTDs in offspring.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.1823","type":"journal-article","created":{"date-parts":[[2020,10,17]],"date-time":"2020-10-17T12:08:29Z","timestamp":1602936509000},"page":"883-893","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Association of paternal smoking with the risk of neural tube defects in offspring: A systematic review and meta\u2010analysis of observational studies"],"prefix":"10.1002","volume":"113","author":[{"given":"Liu","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Xiangya School of Public Health Central South University  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyi","family":"Diao","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health 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