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Article Abstract
Purpose: The increasing global prevalence of maternal smoking during pregnancy raises concerns about lasting effects on fetal neurological development. This review of brain magnetic resonance imaging studies aims to analyze existing literature on the influence of maternal prenatal tobacco exposure on the structure and function of the offspring's brain.
Methods: A systematic search was conducted in PubMed, Web of Science, and Embase for relevant articles published before May 24, 2025. The inclusion criteria consisted of peer-reviewed original articles comparing brain magnetic resonance imaging data of offspring born to mothers with and without prenatal tobacco exposure. A coordinate-based meta-analysis using the activation likelihood estimation was also performed.
Results: Our search resulted in 471 records, with 56 articles undergoing full-text screening. Ultimately, 27 articles comparing the brain magnetic resonance imaging of 15,913 offspring, from fetus to adulthood stages, with and without prenatal tobacco exposure, were included. While the findings of the studies were heterogeneous, multiple regional and global structural (e.g., volume, cortical thickness, and surface area) and functional (task-based) alterations were identified, specifically within the frontal, temporal, and parietal regions. Also, altered white matter tract volume and diffusivity indices were repeatedly reported. Furthermore, our meta-analysis identified reduced neural activity in the right inferior frontal gyrus of tobacco-exposed offspring.
Conclusion: This review highlights a considerable association between maternal smoking during pregnancy and altered offspring brain development. Further studies are essential to discern precise causal effects on the offspring's brain, development, behavior, and function.
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