Relationship of cigarette smoking to congenital anomalies and perinatal death. A prospective study.

Congenital anomalies caused 3.43 perinatal deaths/1000 births, as reported in a large prospective study. At all gestational ages the mortality rates progressively increased when gravidas smoked more than 10 cigarettes/day. An excessive death rate was also found in males, in offspring of mothers over 39 years of age, and in women of low socioeconomic status. Placentas associated with the malformed infants had an increased frequency of single umbilical arteries and abnormal insertions of fetal membranes and umbilical cords into the placenta.