OBJECTIVES: Studies estimating the cost of smoking during pregnancy and the cost-effectiveness of smoking cessation interventions aimed at pregnant women have included a limited number of short-term health outcomes. However, smoking during pregnancy can cause long-term health conditions. There are numerous reviews investigating the impact of maternal smoking during pregnancy (SDP) on particular conditions but a systematic review which examines all health conditions caused by maternal SDP does not exist. Hence, a systematic review of previous reviews to assess the overall impacts of SDP and during the postpartum period on the mother and infant is needed.

METHODS: We conducted an umbrella systematic review according to a protocol submitted to PROSPERO (CRD42018086350). CINAHL, EMBASE, MEDLINE, PsycINFO, Web of Science, CRD and HMIC databases were searched to include all peer-reviewed systematic reviews published in English by 31 December 2017. Quality assessment was undertaken using a checklist based on that developed by the Centre for Reviews and Dissemination. Two reviewers independently conducted the data selection and quality assessment phases.

RESULTS: CONCLUSIONS: When estimating the outcomes of maternal SDP, the long-term health impacts on infants should be considered as well. Additionally, we identified important gaps in the literature regarding the protective impact of smoking, dose-response association, impacts of the exposure duration and postnatal smoking.