The Impact of Maternal Smoking During Pregnancy on Depressive and Anxiety Behaviors in Offspring: A Meta-analysis

Abstract

Smoking during pregnancy is known to adversely affect offspring health; however, the association between maternal smoking during pregnancy and the risk of depression and anxiety in offspring remains inconsistent. This meta-analysis aimed to clarify this relationship. A systematic search was conducted in PubMed, Web of Science, and OVID databases for articles published between 2000 and 2024. The odds ratio (OR) with a 95% confidence interval (CI) was used to assess the association. A total of 11 studies involving 1,775,220 participants met the inclusion criteria. The meta-analysis revealed that maternal smoking during pregnancy was significantly associated with an increased risk of depression in offspring (OR = 1.33, 95% CI = 1.09–1.63). Stratified analysis by cigaret consumption dose showed that heavy maternal smoking (≥ 10 cigarets/day) further increased the risk of both depression (OR = 1.61, 95% CI = 1.21–2.14) and anxiety (OR = 1.51, 95% CI = 1.32–1.72) in offspring. In conclusion, this meta-analysis provides evidence that maternal smoking during pregnancy may elevate the risk of depression and anxiety in offspring, particularly with heavy smoking. Preventing maternal smoking and reducing exposure to tobacco smoke during pregnancy could have significant benefits for offspring mental health and well-being.