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Effects on the fetus In cases of active smoking by a pregnant woman: Increased risk of miscarriage, ectopic pregnancy, and preterm birth Delayed fetal development Lower birth weight (for a given gestational age) In utero fetal death (47% increased risk) Reduced academic and cognitive abilities Development of congenital malformations Secondhand smoke exposure among non-smoking pregnant women whose partners smoke has a measurable effect on the child, although less significant