{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T04:26:58Z","timestamp":1791779218701,"version":"4.3.4"},"reference-count":81,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,12,8]],"date-time":"2024-12-08T00:00:00Z","timestamp":1733616000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100011447","name":"Science and Technology Department of Henan Province","doi-asserted-by":"publisher","award":["24111131130"],"award-info":[{"award-number":["24111131130"]}],"id":[{"id":"10.13039\/501100011447","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":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>A meta\u2010analysis of case\u2010control studies was conducted to assess the risk of birth defects in offspring in China associated with maternal active and passive smoking and paternal smoking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Four electronic databases were searched for qualified research up to December 2023. A Random\u2010effect model or fixed\u2010effect model was used to calculate the overall comprehensive risk estimates; and the relationship between parental smoking and the risk of birth defects in different periods of pregnancy. Subgroup and sensitivity analyses were performed to explore possible sources of heterogeneity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010two qualified studies involving 137,574 cases and 8,770,837 controls were included. Overall, maternal active smoking (OR\u2009=\u20092.19; 95% confidence interval (CI): 1.72\u20132.79; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and passive smoking (OR\u2009=\u20092.59,95% CI: 2.24\u20132.99; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) as well as paternal active smoking (OR\u2009=\u20091.47,95% CI: 1.34\u20131.62; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) were significantly associated with birth defect risk. The sources of heterogeneity were explored by subgroup analysis. Subgroup analysis showed that the risk of congenital heart disease in offspring was increased in paternal and maternal active smoking (OR\u2009=\u20092.97, 95% CI: 2.01\u20134.39; OR\u2009=\u20091.51, 95% CI: 1.30\u20131.74), respectively. Sensitivity analysis yielded consistent results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Maternal active and passive smoking and paternal active smoking are risk factors for birth defects in offspring. Parents should be encouraged to quit smoking during the perinatal period and pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2422","type":"journal-article","created":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T07:25:32Z","timestamp":1733729132000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Parental Smoking and the Risk of Birth Defects in\u00a0Offspring in China: A Systematic Review and\u00a0meta\u2010Analysis"],"prefix":"10.1002","volume":"116","author":[{"given":"Jinxi","family":"Han","sequence":"first","affiliation":[{"name":"Department of Epidemiology, College of Public Health Zhengzhou University  Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunxia","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health Zhengzhou University  Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health Zhengzhou University  Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jikai","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health Zhengzhou University  Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuehua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Henan Children's Hospital Zhengzhou Children's Hospital Children's Hospital Affiliated to Zhengzhou University  Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3300-9453","authenticated-orcid":false,"given":"Kaijuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Henan Children's Hospital Zhengzhou Children's Hospital Children's Hospital Affiliated to Zhengzhou University  Zhengzhou China"},{"name":"Key Laboratory of Tumor Epidemiology of Henan Province Zhengzhou University  Zhengzhou China"},{"name":"State Key Laboratory of Esophageal Cancer Prevention &amp; Treatment Zhengzhou University  Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,8]]},"reference":[{"issue":"3","key":"e_1_2_12_2_1","first-page":"578","article-title":"Analysis of Environmental Exposures for Nonsyndromic Cleft Lip and\/or Palate: A Case\u2010Control Study","volume":"51","author":"Ahmed S. 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