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Maternal Smoking Linked to Increased Risk of Retinoblastoma

Maternal Smoking Linked to Increased Risk of Retinoblastoma

March 24, 2023

Maternal smoking during pregnancy may increase the risk of retinoblastoma, especially in unilateral cases, according to research conducted by Di He, PhD from the Department of Epidemiology at the Fielding School of Public Health, University of California, Los Angeles.

The study was prompted by previous inconclusive results due to the reliance on reported maternal smoking history by study participants. The authors decided to re-examine the link between maternal smoking and retinoblastoma using different methodologies.

As part of the study, researchers utilized biomarkers of tobacco smoke in neonatal dried blood spots to examine the potential association between smoking and retinoblastoma development. The study involved 498 randomly selected cases of retinoblastoma and 895 controls born between 1983 and 2011, and was conducted as a population-based case-control study in California.

The study team evaluated maternal pregnancy-related smoking using multiple metrics, including self-reported or provider-reported smoking during pregnancy, as well as cotinine and hydroxycotinine levels in neonatal blood.

The analysis of these three metrics revealed that "maternal smoking late in pregnancy or early postpartum was related to the development of retinoblastoma (all types, odds ratio, 1.44, 95% confidence interval, 1.00-2.09)."

The researchers found that when they used cotinine or hydroxycotinine to determine maternal smoking status, there was a significant association between maternal smoking and unilateral retinoblastoma (odds ratio, 1.66, 95% confidence interval, 1.08-2.57).

Based on these results, the researchers concluded that maternal smoking could potentially be a risk factor for retinoblastoma development, particularly in cases where cancer affects only one eye.


1. He D, Huang X, Uppal K, et al. Biomarkers of maternal smoking and the risk of retinoblastoma in offspring.Retina. 2023;42:481-9; DOI: 10.1097/IAE.0000000000003678