HMN 2025: How Smoking decline is linked to fewer newborns with gastroschisis

A decline in smoking in the general population, including pregnant people, over the last few decades corresponded with a decline in infants born with a birth defect called gastroschisis, according to research presented during the American Academy of Pediatrics 2025 National Conference & Exhibition, held at the Colorado Convention Center Sept. 26–30.

Authors of an abstract, “A Declining Incidence of Gastroschisis Parallels Trends in Maternal Smoking Rates in the United States,” point to the success of public health efforts to discourage smoking within the general population.

Consequently, a decline in maternal smoking prior to conception led to fewer diagnoses of gastroschisis, a condition in which a baby is born with their organs outside of their body due to their abdominal wall not forming completely in the womb, according to the study.

Researchers reviewed live birth data released by the U.S. Department of Health and Human Services between 2017 and 2023, identifying 5,121 newborns out of a total of 25,836,224 live births who were diagnosed with gastroschisis. Among these, 858 (16.75%) were born to mothers with a history of smoking prior to pregnancy.

Maternal smoking decreased in a linear fashion from 9.4% in 2017 to 4.1% in 2023, according to the research. Concurrently, the incidence of gastroschisis also decreased linearly from 2.4 per 10,000 births in 2017 to 1.6 per 10,000 births in 2023. The odds of a gastroschisis diagnosis increased by 39% for each additional 10 cigarettes smoked daily prior to conception, researchers found.

“Epidemiologic studies such as this demonstrate that rare diseases, such as gastroschisis, may be significantly altered at a population level by the most common of health interventions, such as cessation of maternal smoking,” said Zane Hellmann, MD MHS, general surgery resident.

“Public health investments in initiatives such as this can pay dividends in ways that are not initially obvious, such as reducing the rates of congenital abnormalities in the progeny of those encouraged to lead healthier lives,” he said.

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