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Figuras y tablas -
Figure 1

Risk of bias summary: review authors' judgments about each risk of bias item for each included study.
Figuras y tablas -
Figure 2

Risk of bias summary: review authors' judgments about each risk of bias item for each included study.

Risk of bias graph: review authors' judgments about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 3

Risk of bias graph: review authors' judgments about each risk of bias item presented as percentages across all included studies.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 1 Continued smoking in late pregnancy.
Figuras y tablas -
Analysis 1.1

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 1 Continued smoking in late pregnancy.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 2 Continued smoking in pregnancy subgrouped by risk of bias.
Figuras y tablas -
Analysis 1.2

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 2 Continued smoking in pregnancy subgrouped by risk of bias.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 3 Continued smoking in late pregnancy by intensity of intervention.
Figuras y tablas -
Analysis 1.3

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 3 Continued smoking in late pregnancy by intensity of intervention.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 4 Continued smoking in late pregnancy subgrouped by main intervention strategy.
Figuras y tablas -
Analysis 1.4

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 4 Continued smoking in late pregnancy subgrouped by main intervention strategy.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 5 Continued smoking (relapse) for spontaneous quitters in late pregnancy.
Figuras y tablas -
Analysis 1.5

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 5 Continued smoking (relapse) for spontaneous quitters in late pregnancy.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 6 Mean birthweight.
Figuras y tablas -
Analysis 1.6

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 6 Mean birthweight.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 7 Mean birthweight subgrouped by main intervention strategy.
Figuras y tablas -
Analysis 1.7

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 7 Mean birthweight subgrouped by main intervention strategy.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 8 Low birthweight (under 2500 g).
Figuras y tablas -
Analysis 1.8

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 8 Low birthweight (under 2500 g).

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 9 Very low birthweight (under 1500 g).
Figuras y tablas -
Analysis 1.9

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 9 Very low birthweight (under 1500 g).

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 10 Perinatal deaths.
Figuras y tablas -
Analysis 1.10

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 10 Perinatal deaths.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 11 Preterm birth (under 37 or under 36 weeks).
Figuras y tablas -
Analysis 1.11

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 11 Preterm birth (under 37 or under 36 weeks).

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 12 Stillbirths.
Figuras y tablas -
Analysis 1.12

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 12 Stillbirths.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 13 Neonatal deaths.
Figuras y tablas -
Analysis 1.13

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 13 Neonatal deaths.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 14 NICU admissions.
Figuras y tablas -
Analysis 1.14

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 14 NICU admissions.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 15 Smoking reduction: numbers of women reducing smoking in late pregnancy.
Figuras y tablas -
Analysis 1.15

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 15 Smoking reduction: numbers of women reducing smoking in late pregnancy.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 16 Smoking reduction: biochemical measures in late pregnancy.
Figuras y tablas -
Analysis 1.16

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 16 Smoking reduction: biochemical measures in late pregnancy.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 17 Smoking reduction: self‐reported mean cigarettes per day measured in late pregnancy or at delivery.
Figuras y tablas -
Analysis 1.17

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 17 Smoking reduction: self‐reported mean cigarettes per day measured in late pregnancy or at delivery.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 18 Maintained smoking cessation at 1‐5 months postpartum.
Figuras y tablas -
Analysis 1.18

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 18 Maintained smoking cessation at 1‐5 months postpartum.

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 19 Maintained smoking cessation at 6 to 12 months postpartum.
Figuras y tablas -
Analysis 1.19

Comparison 1 Interventions for smoking cessation in pregnancy versus control, Outcome 19 Maintained smoking cessation at 6 to 12 months postpartum.

Comparison 1. Interventions for smoking cessation in pregnancy versus control

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Continued smoking in late pregnancy Show forest plot

65

21258

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.93, 0.96]

1.1 Individually randomised trials

56

15915

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.92, 0.96]

1.2 Cluster‐randomised trials

9

5343

Risk Ratio (M‐H, Random, 95% CI)

0.97 [0.94, 1.00]

2 Continued smoking in pregnancy subgrouped by risk of bias Show forest plot

64

21117

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.93, 0.96]

2.1 Low risk of bias (biochem val + ITT +ad. rand.)

14

5691

Risk Ratio (M‐H, Random, 95% CI)

0.97 [0.94, 0.99]

2.2 Moderate risk of bias (biochem val only)

35

11638

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.92, 0.97]

2.3 High risk of bias (no biochem validation)

15

3788

Risk Ratio (M‐H, Random, 95% CI)

0.91 [0.87, 0.95]

3 Continued smoking in late pregnancy by intensity of intervention Show forest plot

65

21258

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.93, 0.96]

3.1 High intensity

44

14453

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.92, 0.96]

3.2 Medium intensity

18

5670

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.92, 0.98]

3.3 Low intensity

3

1135

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.83, 1.09]

4 Continued smoking in late pregnancy subgrouped by main intervention strategy Show forest plot

65

21257

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.93, 0.96]

4.1 Cognitive behaviour strategies

30

9570

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.93, 0.97]

4.2 Stages of change

11

5073

Risk Ratio (M‐H, Random, 95% CI)

0.99 [0.97, 1.00]

4.3 Feedback

4

572

Risk Ratio (M‐H, Random, 95% CI)

0.92 [0.84, 1.02]

4.4 Rewards

4

1285

Risk Ratio (M‐H, Random, 95% CI)

0.76 [0.71, 0.81]

4.5 Pharmacotherapy (NRT, Bupropion etc) nicotine replacement therapy

5

1147

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.92, 0.98]

4.6 Other

11

3610

Risk Ratio (M‐H, Random, 95% CI)

0.96 [0.93, 0.98]

5 Continued smoking (relapse) for spontaneous quitters in late pregnancy Show forest plot

8

1064

Risk Ratio (M‐H, Random, 95% CI)

0.91 [0.75, 1.10]

6 Mean birthweight Show forest plot

21

15119

Mean Difference (IV, Random, 95% CI)

39.26 [15.77, 62.74]

7 Mean birthweight subgrouped by main intervention strategy Show forest plot

21

15119

Mean Difference (IV, Random, 95% CI)

39.26 [15.77, 62.74]

7.1 Cognitive behavioural therapy

9

3809

Mean Difference (IV, Random, 95% CI)

47.01 [12.22, 81.80]

7.2 Stages of change

2

1312

Mean Difference (IV, Random, 95% CI)

‐5.84 [‐66.40, 54.72]

7.3 Feedback

3

6611

Mean Difference (IV, Random, 95% CI)

47.80 [‐14.67, 110.28]

7.4 Rewards

2

1008

Mean Difference (IV, Random, 95% CI)

123.98 [‐1.92, 249.89]

7.5 Pharmacotherapy

3

1078

Mean Difference (IV, Random, 95% CI)

34.40 [‐125.77, 194.58]

7.6 Other

2

1301

Mean Difference (IV, Random, 95% CI)

36.27 [‐18.71, 91.25]

8 Low birthweight (under 2500 g) Show forest plot

16

9916

Risk Ratio (M‐H, Random, 95% CI)

0.83 [0.73, 0.95]

9 Very low birthweight (under 1500 g) Show forest plot

4

5496

Risk Ratio (M‐H, Random, 95% CI)

1.16 [0.69, 1.96]

10 Perinatal deaths Show forest plot

3

4335

Risk Ratio (M‐H, Random, 95% CI)

1.13 [0.72, 1.77]

11 Preterm birth (under 37 or under 36 weeks) Show forest plot

14

11930

Risk Ratio (M‐H, Random, 95% CI)

0.86 [0.74, 0.98]

12 Stillbirths Show forest plot

6

4706

Risk Ratio (M‐H, Random, 95% CI)

1.10 [0.69, 1.76]

13 Neonatal deaths Show forest plot

3

4143

Risk Ratio (M‐H, Random, 95% CI)

1.17 [0.34, 4.01]

14 NICU admissions Show forest plot

4

1394

Risk Ratio (M‐H, Random, 95% CI)

0.85 [0.61, 1.18]

15 Smoking reduction: numbers of women reducing smoking in late pregnancy Show forest plot

13

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

15.1 Self‐reported some reduction in smoking (various definitions)

5

1487

Risk Ratio (M‐H, Random, 95% CI)

1.52 [1.29, 1.78]

15.2 Self‐reported > 50% reduction in smoking

3

779

Risk Ratio (M‐H, Random, 95% CI)

1.23 [0.91, 1.67]

15.3 Biochemically validated reduction

5

1549

Risk Ratio (M‐H, Random, 95% CI)

1.27 [0.84, 1.91]

16 Smoking reduction: biochemical measures in late pregnancy Show forest plot

4

2511

Std. Mean Difference (IV, Random, 95% CI)

‐0.11 [‐0.24, 0.02]

16.1 Mean cotinine levels

3

1742

Std. Mean Difference (IV, Random, 95% CI)

‐0.05 [‐0.14, 0.05]

16.2 Mean thiocynate level

1

769

Std. Mean Difference (IV, Random, 95% CI)

‐0.29 [‐0.44, ‐0.15]

17 Smoking reduction: self‐reported mean cigarettes per day measured in late pregnancy or at delivery Show forest plot

9

3372

Mean Difference (IV, Random, 95% CI)

‐0.67 [‐1.49, 0.16]

18 Maintained smoking cessation at 1‐5 months postpartum Show forest plot

20

6097

Risk Ratio (M‐H, Random, 95% CI)

1.65 [1.22, 2.24]

18.1 Individually randomised trials

15

4726

Risk Ratio (M‐H, Random, 95% CI)

1.43 [1.08, 1.91]

18.2 Cluster‐randomised trials

5

1371

Risk Ratio (M‐H, Random, 95% CI)

2.08 [0.78, 5.56]

19 Maintained smoking cessation at 6 to 12 months postpartum Show forest plot

8

2624

Risk Ratio (M‐H, Random, 95% CI)

1.39 [0.82, 2.38]

19.1 Individually randomised trials

8

2624

Risk Ratio (M‐H, Random, 95% CI)

1.39 [0.82, 2.38]

19.2 Cluster‐randomised trials

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 1. Interventions for smoking cessation in pregnancy versus control