Date of Graduation

Winter 1-1-2011

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Torry Cobb

Abstract

Background: Cigarette smoking during pregnancy is a common practice and its impact on the development of the lungs of the ensuing child has proven to be detrimental. Recent studies have been done to determine whether prenatal smoking is associated with asthma in the resultant child. Five of the most pertinent studies on this topic will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) in this systematic review.

Method: An exhaustive search of the medical literature was conducted through EBM Reviews, Medline, CINAHL, and PubMed databases which yielded five studies for final review.

Results: Three cohort studies and two case control studies were reviewed. All studies obtained data by parental questionnaires or health registries but data was gathered either prospectively or retrospectively depending on study design. Smoking during pregnancy was associated with childhood asthma, current asthma, and wheezing as compared with children who had a prenatal environment free from cigarette smoke.

Conclusion: Smoking during pregnancy is associated with childhood asthma and current asthma and there is a direct correlation between the amount of cigarettes smoked and the degree of damage. Combining the evidence for the outcomes of asthma and asthma-like symptoms via the GRADE criterion yielded a moderate quality of evidence, showing that the studies are of good quality and of value, but further research must be done to be confident in the magnitude of effect estimates and the accuracy of the results.

Keywords: asthma, pregnancy, cigarette, smoking

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