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Partner cigarette smoking and risk of neural tube defects among infants of non-smoking women in northern China
  1. Zhiwen Li1,2,
  2. Le Zhang1,2,
  3. Rongwei Ye1,2,
  4. Jianmeng Liu1,2,
  5. Lijun Pei3,
  6. Xiaoying Zheng3,
  7. Aiguo Ren1,2
  1. 1Institute of Reproductive and Child Health, Ministry of Health, Key Laboratory of Reproductive Health, Peking University, Beijing, China
  2. 2Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
  3. 3Institute of Population Research, WHO Collaborating Center on Reproductive Health and Population Science, Peking University, Beijing, China
  1. Correspondence to Aiguo Ren, Institute of Reproductive and Child Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing 100191, China; renag{at}


Objectives To investigate the effect of secondhand smoke exposure from a partner on the risk of having a newborn baby with neural tube defects (NTDs) in Chinese non-smoking women.

Methods Data were derived from an on-going population-based case–control study of external malformations in northern China. The case group included 580 infants or fetuses with NTDs identified between November 2002 and December 2007. Controls were 795 newborn infants without major external malformations. Data were collected by trained health workers through face-to-face interviews within 1 week after delivery.

Results A total of 81.4% of partners of case women and 71.8% of partners of control women smoked during the women's peri-conceptional period. The adjusted OR for NTDs associated with partner smoking was 1.6 (95% CI 1.2 to 2.1). Compared with non-smoking women with non-smoking partners, fetal NTD risk among women with smoking partners was 1.7 (1.3 to 2.4) and 1.1 (0.7 to 1.7) for women exposed and not exposed to partner smoking, respectively. Among women who were exposed to partner smoking, the risk of NTDs was 1.4 (0.9 to 2.0), 1.8 (1.2 to 2.6), 1.9 (1.2 to 3.0) and 2.7 (1.6 to 4.7) for partner smoking of <1, 1–9, 10–19 and ≥20/day, respectively (p for trend <0.001).

Conclusion Peri-conceptional exposure to partner smoking may increase the risk of NTDs in the offspring of Chinese non-smoking women.

  • Partner smoking
  • secondhand smoke
  • neural tube defects
  • socioeconomic status
  • low/middle-income country
  • smoking-caused disease

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  • Funding This work was supported in part by the National Natural Science Foundation of China (grant no. 31071315) and by the State Key Development Program for Basic Research (grant no. 2007CB5119001), People's Republic of China.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Institutional Review Board of Peking University Health Science Center.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement More details about our original research can be found in Li et al.13