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Using code sheets prepared at birth of 48,505 women in worldwide naval installations. Underwood et al. (1967) found that fathers’ smoking habits influenced pregnancy outcome. However, this was attributed to the increased numbers of wives who smoked when husbands smoked. For paternal smoking in the absence of maternal smoking, no association was found. Holmberg and Nurminen (1980) and Hughes et al. (1982) also reported no association of paternal smoking with low birthweight in cross-sectional reviews of several thousand births.

Rubin et al. (1986) provide a recent contribution to this subject based on a survey of 500 consecutive births. About two-fifths of the women reported smoking during pregnancy; 70 percent reported drinking. Paternal smoking was evaluated in terms of frequency and quantity of substance smoked, as reported in standardized interviews. They found that birthweight was reduced an average of 120 g per pack of cigarettes smoked per day by the father. This relationship remained statistically significant after controlling for relevant variables, including mother’s age, parity, maternal smoking, and alcohol and tobacco consumption during pregnancy. The effect was greatest in the lower social classes.

In a prospective study, Martin and Bracken (1986) studied 3,891 antenatal patients, 2,613 of whom did not smoke during pregnancy. One-third of the nonsmoking mothers (i.e., 906) were exposed to ETS for at least 2 hours per day. ETS exposure was related to lower birthweight in full-term babies (23.5 g, not significant). A logistic regression to control for gestational age, parity, ethnicity, and maternal age produced a significantly increased risk of delivering a low-birthweight baby, i.e., less than 2,500 g at birth for ETS-exposed mothers (relative risk=2.17, p<0.05). The retardation in fetal growth rate is small but appears to be clinically meaningful at the low end of the birthweight distribution. That is, exposure to ETS increases the risk that the infant will weigh less than 2,500 g and, therefore, will have a higher perinatal mortality.

GROWTH IN CHILDREN

A few studies have examined possible relationships between chronic exposure to ETS by children and parameters of growth and development. Many studies have demonstrated that smoking during pregnancy results in newborns who are lighter and shorter than other infants, even when gestational age has been taken into



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