Link between smoking and stillbirth

The link between smoking and stillbirth is dose-dependent, according to new research flagged up by NICE.

NICE’s Eyes on Evidence update, which provides commentary on important new evidence, said that a pooled analysis of 24 studies, which had more than eight million participants, found that the risk of stillbirth was 47% higher in women who smoked during pregnancy than in women who did not smoke while pregnant, but that this increased to  52% higher in pregnant women who smoked 10 or more cigarettes per day.

RCM professional policy advisor Janet Fyle said that the new research presents both a challenge and opportunity to midwives:

“On one hand, the research supports current practice, making the link between smoking and the risk of stillbirth. It also highlights that the risk is increased if the woman smokes heavily.  On the other hand, the research may influence what messages women internalise in relation to their own behaviour. A pregnant woman who finds it difficult to stop smoking completely may interpret the research as suggesting she should reduce the number of cigarettes she smokes to less than 10 a day….The fact is that the causes of stillbirths are multifactorial. Although any smoking increases risk, women who do not smoke can still have stillbirths. It will be a challenge for people who work in health care to represent this evidence – “reducing your dose reduces your risk” – while also conveying to women that being a non-smoker has many long-term benefits, stillbirths notwithstanding.”

NICE has said that women should continue to be advised that stopping smoking at any time during the pregnancy offers significant benefits for mother and baby.

For more on this story read the research here
RCM article here