medRxiv PreprintsInternational2 October 2026
Maternal Cigarette Smoking Trajectories and Risk of Low Birthweight in the United States: A Population-Based Analysis of 2023 to 2024 Natality Data
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Background: Maternal cigarette smoking is associated with adverse birth outcomes, but low birthweight may reflect preterm delivery, restricted fetal growth, or both. Contemporary evidence distinguishing smoking trajectories is limited. Objectives: To examine associations between maternal cigarette-smoking trajectories and low birthweight among U.S.-resident singleton live births in 2023 to 2024. Methods: We analyzed 5,861,166 U.S.-resident singleton live births in the 2023 to 2024 National Vital Statistics System natality files. Low birthweight was defined as birthweight <2,500 g. Trajectories
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