Maternal smoking during pregnancy and risk of cryptorchidism: a systematic review and meta-analysis

  • Chengjun Yu
  • Yi Wei
  • Xiangliang Tang
  • Bin Liu
  • Lianju Shen
  • Chunlan Long
  • Tao Lin
  • Dawei He
  • Shengde WuEmail author
  • Guanghui Wei
Original Article


The risk factors for undescended testes in male infants and the underlying pathogenesis still remain unclear. The aim of this study is to identify the relationship between maternal smoking during pregnancy and risk of cryptorchidism. A systematic review was conducted using appropriate search terms to identify articles pertaining to maternal smoking during pregnancy and risk of cryptorchidism. Entries up to December 23, 2017 were taken into consideration, without any language or regional restriction. The crude ORs and their 95% CIs were computed by using the fixed-effect model. Twenty studies involving 111,712 infants were included in our meta-analysis. The risk of having a male infant with cryptorchidism was significantly different between mothers who smoked during pregnancy and those who did not (pooled crude OR 1.18, 95% confidence interval [CI] 1.12–1.24, p < 0.00001).

Conclusion: Our findings suggest that smoking during pregnancy increased the risk of cryptorchidism by 1.18 times. Further investigations that are well-designed, multicentric studies measuring variables, such as the number of cigarettes smoked in a day and the stage of pregnancy during which the mothers smoked, are necessary to precisely determine the relationship between maternal smoking and risk of cryptorchidism.

What is Known:

Preterm and low birth weight have been definitively shown to be risk factors for cryptorchidism.

The relationship between with maternal smoking during pregnancy and risk of cryptorchidism remains controversial all the time.

What is New:

Mothers who smoked during pregnancy had a 1.18 times higher risk of having a child with cryptorchidism as compared to those who did not smoke.

Evidence has been found that maternal smoking during pregnancy is a definitive risk factor for cryptorchidism.


Cryptorchidism Maternal smoking Meta-analysis 



Confidence interval


Odds ratio



I would acknowledge the support of Dept. of Urology of Children’s Hospital of Chongqing Medical University, the financial support of National Natural Science Foundation of China, and I would especially express my thanks to Professor John Hutson for language editing.

Authors’ contributions

CJY and SDW conceived and designed the meta-analysis. CJY and YW independently searched the Pubmed, Cochrane Librery, Web of Science database, China National Knowledge Infrastructure (CNKI), WanFang Data, VIP database and China Biology Medical disc (CBM), and independently extracted the data. CJY led analysis and interpretation of data, drafted the manuscript and revised content based on feedback. YW acted as second reviewer. XLT and BL assisted with the retrieval of the database and acquisition of data. LJS and CLL assisted with the interpretation of data and provided critical revision of drafts. TL, DWH, and GHW assisted with the conception and design, interpretation of data, and critical revision of drafts. SDW acted as the corresponding author, provided funding support, assisted with interpretation of data, provided critical revision of drafts and acted as the third (mediating) reviewer.


This study is supported by the National Natural Science Foundation of China (No. 81571425), Scientific and Technological Research Program of Chongqing Municipal Education Commission (KJ1600229), and Postgraduate scientific research innovation project of Chongqing Medical university (CYB16105).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018
corrected publication 2019

Authors and Affiliations

  1. 1.Department of UrologyChildren’s Hospital of Chongqing Medical UniversityChongqing CityChina
  2. 2.Chongqing Key Laboratory of Children Urogenital Development and Tissue EngineeringChongqingChina
  3. 3.Ministry of Education Key Laboratory of Child Development and DisordersChongqingChina
  4. 4.China International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqingChina
  5. 5.Chongqing Key Laboratory of Pediatrics ChongqingChongqingChina

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