Skip directly to search Skip directly to A to Z list Skip directly to page options Skip directly to site content

Key Findings: Maternal Smoking and Congenital Heart Defects

Man and Woman talking

The journal Pediatrics has published a new CDC article: "Maternal Smoking and Congenital Heart Defects in the Baltimore-Washington Infant Study". You can read the abstract of the article here. Following is a summary of the findings from this article.

About congenital heart defects and this study:

Congenital heart defects are conditions present at birth that can affect the way the heart works. They can cause lifelong disability or death. They are the most common type of birth defect, affecting nearly 40,000 births in the United States each year1. They are also a leading cause of infant death2.

Previous studies looking at whether cigarette smoking increases the risk of a baby being born with a congenital heart defect have found mixed results. However, a number of studies have found maternal cigarette smoking to be a modest risk factor for certain heart defects, such as transposition of the great arteries, atrial septal defects, and right ventricular outflow tract obstruction defects. For this study, researchers used data from the Baltimore-Washington Infant Study (BWIS) to see if maternal cigarette smoking during the first trimester increased the risk of a baby being born with a congenital heart defect. The BWIS is a population-based, case-control study of congenital heart defects conducted from 1981 through 1989 in Maryland; Washington, D.C.; and some counties in Virginia.

Quitting Smoking

Quitting smoking can be hard, but it is one of the best ways a woman can protect herself and her baby's health. Quitting smoking before getting pregnant is best. But for a woman who is already pregnant, quitting as early as possible can still help protect against some health problems for the baby, such as low birthweight. For free help, call 1-800-QUIT-NOW (1-800-784-8669).

Main findings from this study include:

  • Maternal cigarette smoking during the first trimester  was linked with the following heart defects:
    • Atrial septal defects, type 2
    • Right ventricular outflow tract obstruction defects, specifically pulmonary valve stenosis
    • Truncus arteriosus
    • L-transposition of the great arteries

These findings add to the existing body of evidence linking maternal cigarette smoking during the first trimester with the occurrence of some heart defects. These findings are consistent with findings from previous studies, including those from the National Birth Defects Prevention Study, suggesting that maternal cigarette smoking during the first trimester of pregnancy might be a modest risk factor for certain heart defects.

Congenital heart defects: CDC activities

We at the Centers for Disease Control and Prevention (CDC) work to identify causes and prevention opportunities for congenital heart defects by applying a comprehensive public health approach:

  • Surveillance or disease tracking: Tracking where and when congenital heart defects occur and who they affect gives us important clues about opportunities for prevention.
  • Research: CDC coordinates the largest population-based effort in the United States to identify the causes of birth defects, the National Birth Defects Prevention Study. Population-based means that the researchers look at all babies with birth defects who live in the study regions. This study has identified some important risk factors for congenital heart defects.
  • Prevention: Studying the occurrence of congenital heart defects among the population holds promise for identifying risk factors that can be translated into prevention strategies.
  • Collaboration: CDC provides technical assistance to the Congenital Heart Public Health Consortium, a unique collaboration that brings together families, experts, and organizations to address congenital heart defects.

More Information

To learn more about birth defects, please visit
To learn more about smoking during pregnancy, please visit

  • Reller MD, Strickland MJ, Riehle-Colarusso T, Mahle WT, Correa A. Prevalence of congenital heart defects in Metropolitan Atlanta, 1998-2005. J Pediatr. 2008;153(6):807–13.
  • Petrini J, Damus K, Russell R, Poschman K, Davidoff MJ, Mattison D. Contribution of birth defects to infant mortality in the United States. Teratology. 2002;66 Suppl 1:S3–6.
Reference for Key Findings Summary:

Alverson CJ, Strickland MJ, Gilboa SM, Correa A. Maternal Smoking and Congenital Heart Defects in the Baltimore-Washington Infant Study. Pediatrics. 2011 [Epub ahead of print]

Error processing SSI file