Maternal cigarette smoking may affect the intrauterine hormonal environment during pregnancy and this early fetal exposure may
have detrimental effects on the future trajectory of reproductive health. In this review, we discuss the epidemiological literature on
the association between prenatal exposure to maternal cigarette smoking and several aspects of reproductive health. The literature
points towards an increased risk of the urogenital malformation cryptorchidism, but a potential protective effect on the risk of
hypospadias in sons following prenatal cigarette smoking exposure. Studies on sexual maturation fi nd a tendency towards accelerated
pubertal development in exposed boys and girls. In adult life, prenatally exposed men have impaired semen quality compared with
unexposed individuals, but an infl uence on fecundability, that is, the biological ability to reproduce, is less evident. We found no
evidence to support an association between prenatal cigarette smoking exposure and testicular cancer. Among adult daughters,
research is sparse and inconsistent, but exposure to cigarette smoking in utero may decrease fecundability. In conclusion, prenatal
exposure to cigarette smoking may cause some long-term adverse effects on the reproductive health.

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