Is there a link between smoking during pregnancy and allergic rhinitis in the offspring?

A pregnant woman sits on a park bench smoking a cigarette.


In the meantime, there are many studies that prove that tobacco exposure of the mother during a period of pregnancy can possibly affect the health of the offspring. According to statistics, around 20 to 30 % of pregnant women in Austria smoke. Due to a lack of causal relationships, researchers now investigated a possible correlation between tobacco consumption during pregnancy and allergic rhinitis in the children.

A pregnant woman sits on a park bench smoking a cigarette. / UA-pro

Allergic rhinitis in offspring

Allergic rhinitis, also known as allergic rhinitis, is a common chronic inflammation of the nasal mucosa (i.e. rhinitis) and is mediated by immunoglobulin E (i.e. antibody responsible for allergies). It is estimated that allergic rhinitis affects 10% to 25% of the human population globally. Typically, the disease manifests in early childhood and can lead to decades of impaired quality of life. Classic symptoms of the disease closely associated with asthma would be:

  • Itching of the nose and eyes
  • Sneezing
  • Rhinorrhea and nasal congestion
  • Watery eyes

Not only active smoking, but also passive smoking as an environmental factor can be linked to allergic rhinitis. A meta-analysis published in 2014 found an association between passive smoking in the general population and the risk of allergic rhinitis in non-pregnant women. According to this study, the amount of smoke produced is thought to pollute the surrounding air, increase allergens, and irritate the mucous membranes with harmful cigarette components such as formaldehydeor acrolein. Subsequently, vasospasm (i.e., spasmodic constriction of blood-bearing vessels) and contraction of the rhinitis occurs - which in turn (with long-term exposure) can lead to disruption of the hair cells in the nose. This can cause allergic rhinitis. As current studies have not been able to show clear results regarding tobacco exposure and its risks within the uterus of a pregnant woman, a team of researchers has now used a meta-analysis to investigate the link in the offspring.

Epigenetic link

The meta-analysis, published in 2021 in the Journal Medicine, examined relevant literature in channels such as SinoMed, PubMed, and Web of Science, and performed extensive quality assessment, data extraction, and data analysis. The following criteria were applied for inclusion or selection:

  1. Study type: cohort, case-control, or cross-sectional.
  2. Primary outcome was allergic rhinitis in offspring, with physician diagnosis, skin prick test (i.e. allergens are dripped on the skin, then that site is scratched) or International Study of Asthma and Allergy in Childhood (ISAAC) questionnaires.
  3. Exposure to tobacco was smoking (active and passive) by the pregnant mother.
  4. The studies included enough data on risk estimates with odds ratio (i.e. odds ratio) and range of expectation (i.e. confidence intervals) or their calculation.


A total of 1,149,879 samples were analyzed across 16 articles and 22 independent datasets. The study showed an increased risk of allergic rhinitis in offspring as a result of tobacco exposure during pregnancy of at least 13%. Maternal passive smoking during the pregnancy period recorded the highest risk of 39%. Other epidemiological studies have shown that adverse effects from smoke-induced environmental exposures develop around the time of delivery and are strongly associated with the development of asthma or allergic diseases in the newborns. Other clinical studies showed further smoke association with lower birth weight of the newborns, which in turn may be associated with increased risk of asthma or impaired lung function.


According to the published meta-analysis, tobacco exposure throughout the gestational period may significantly increase the risk of allergic rhinitis in the newborns due to several factors. The researchers recommend reducing smoking during the period before the child is born to minimize genetic risk factors. Furthermore, studies exist showing that parental allergy alone could generically increase the risk of allergic rhinitis in offspring. In the absence of studies on this - whether there is an association between tobacco exposure during pregnancy together with parental allergy and allergic rhinitis in the child - analyses are still needed to clarify a definite association between the allergic and epigenetic effects of smoking.


Editorial principles

All information used for the content comes from verified sources (recognised institutions, experts, studies by renowned universities). We attach great importance to the qualification of the authors and the scientific background of the information. Thus, we ensure that our research is based on scientific findings.
Danilo Glisic

Danilo Glisic

As a biology and mathematics student, he is passionate about writing magazine articles on current medical topics. Due to his affinity for facts, figures and data, his focus is on describing relevant clinical trial results.

The content of this page is an automated and high-quality translation from DeepL. You can find the original content in German here.

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