Who smokes during pregnancy?: A systematic literature review of population-based surveys conducted in developed countries between 1997 and 2006

Objectives Smoking during pregnancy is a major risk for the unborn child. Reliable data on the relevant high-risk groups are essential for devising effective preventive and interventional programmes. This review aims at identifying factors which differentiate women who smoke during pregnancy from those who do not, in developed countries. Methods This systematic literature review is based solely on empirical original papers with population-representative samples of pregnant women. All studies concerned developed countries and were published between 1997 and 2006. Two blinded investigators working in parallel selected the papers in accordance with the recommendations formulated in the QUOROM Statement. Cross-checking was then carried out to identify any differences. Results A total of 17 studies were identified. Correlates for smoking during pregnancy can be grouped according to biological, material/structural, psychosocial and behavioural factors. Women of younger age, with a low social status, a large number of children, without a partner or with a partner who smokes, and deficient prenatal care, are more likely to smoke than women in the respective reference groups. Conclusions This study identified risk groups with an above-average prevalence of smoking during pregnancy. These risk groups are a key target population for preventive measures.