{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T10:58:43Z","timestamp":1789901923177,"version":"4.0.1"},"reference-count":35,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,11,23]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Smoking during pregnancy is associated with adverse health impacts on mother and child. We used a large linked Scottish dataset to produce contemporary estimates of the impact on child health, particularly hospitalisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study linking birth, death, maternity, infant health, child health surveillance and admission records. We examined the association between smoking status at maternity booking and pregnancy outcomes, hospital admission and death during the first 5\u2009years of life. Models were adjusted for maternal age, socioeconomic status, infant feeding, country of birth, sex, parity and delivery mode. We calculated population attributable fraction (PAF) for each outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Scotland, UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Singleton births between 1997 and 2009 (n=697\u2009003) followed to March 2012.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>332\u2009386 children had at least one admission by 31 March 2012. There were 56\u2009588 born small for gestational age, 40\u2009492 prematurely and 1074 postneonatal deaths. Within the first 5 years of life, 56\u2009615 children had at least one admission for acute respiratory infections, 24\u2009088 for bronchiolitis and 7549 for asthma. Maternal smoking significantly increased admission for acute respiratory infections (adjusted HR 1.29, 95% CI 1.25 to 1.34, PAF 6.7%) and bronchiolitis (HR 1.43, 95% CI 1.38 to 1.48 under 1\u2009year, PAF 10.1%), asthma (HR 1.29, 95% CI 1.22 to 1.37 age 1\u20135 years, PAF 7.1%) and bacterial meningitis (HR 1.49, 95% CI 1.30 to 1.71, PAF 11.8%) age 0\u20135 years. Neonatal mortality (adjusted OR 1.32, 95% CI 1.17 to 1.49, PAF 6.7%), postneonatal mortality (OR 2.18, 95% CI 1.87 to 2.53, PAF 22.3%), small for gestational age (OR 2.67, 95% CI 2.62 to 2.73, PAF 27.5%) and prematurity (OR 1.41, 95% CI 1.37 to 1.44, PAF 8.8%) were higher among the offspring of smokers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Smoking during pregnancy causes significant ill health and death among children born in Scotland. These findings support continued investment to reduce smoking among women before, during and after pregnancy as 50% of women will go on to have further children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-023213","type":"journal-article","created":{"date-parts":[[2019,3,21]],"date-time":"2019-03-21T05:36:43Z","timestamp":1553146603000},"page":"e023213","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":36,"title":["Impact of maternal smoking on early childhood health: a retrospective cohort linked dataset analysis of 697 003 children born in Scotland 1997\u20132009"],"prefix":"10.1136","volume":"9","author":[{"given":"Richard","family":"Lawder","sequence":"first","affiliation":[{"name":"Information Services Division, NHS National Services Scotland, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Whyte","sequence":"additional","affiliation":[{"name":"Glasgow Centre for Population Health, University of Glasgow, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Wood","sequence":"additional","affiliation":[{"name":"Information Services Division, NHS National Services Scotland, Edinburgh, UK"},{"name":"Child Life and Health, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Fischbacher","sequence":"additional","affiliation":[{"name":"Information Services Division, NHS National Services Scotland, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Michael","family":"Tappin","sequence":"additional","affiliation":[{"name":"Scottish Cot Death Trust, 5th Floor, West Glasgow Ambulatory Care Hospital, University of Glasgow, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,3,20]]},"reference":[{"key":"2025121403022478000_9.3.e023213.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62233-7"},{"key":"2025121403022478000_9.3.e023213.2","unstructured":"ONS (Office for National Statistics). 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