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The ROS is a single summary of the effect of smoking on the outcome, with higher positive ROSs corresponding to stronger and more consistent evidence and a higher average effect size of smoking and a negative ROS, suggesting that, based on the available evidence, there is no significant effect of smoking on the outcome after accounting for between-study heterogeneity

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71 Other Adverse Health Impacts Further impacts of smoking during pregnancy include: Increased risk of congenital defects in the offspring of smokers, 72 including orofacial clefts

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