Smoking while pregnant significantly increases the risk of serious birth defects, according to a new report.
Researchers found the chance of a baby being born with missing or deformed limbs is 26% higher for smokers, and cleft lip or palate is 28% more likely.
Similarly, the risk of clubfoot is 28% greater, gastrointestinal defects 27% more likely, while skull defects are 33% and eye defects 25% more common.
The greatest increase in risk – of 50% – was for a condition called gastroschisis, where parts of the stomach or intestines protrude through the skin.
In England and Wales 17% of women smoke during pregnancy, meaning around 119,000 of the 700,000 babies born each year are born to mums who smoke.
While the higher chance of miscarriage and low birth weight are well-known risks associated with smoking in pregnancy, there has been uncertainty in the past regarding which birth defects are directly linked to smoking.
Researchers looked at 172 research papers published in the past 50 years to carry out the first comprehensive review of the physical effects of tobacco on newborn babies.
“Now we have this evidence, advice should be more explicit about the kinds of serious defects that babies of mothers who smoke during pregnancy could suffer from,” said Professor Allan Hackshaw, from University College London, who led the research.