Brand DS, et al. - Researchers performed a National register-based birth cohort study to evaluate the impact of maternal smoking during pregnancy on fractures in offspring during different developmental stages of life in Sweden. Between 1983 and 2000, a sum of 1,680,307 people born in Sweden to women who smoked (n = 377,367, 22.5%) and did not smoke (n = 1,302,940) in early pregnancy were included. A total of 377,970 fractures were observed (the overall incidence rate for fracture standardized by the calendar year of birth was 11.8 per 1000 person-years) during a median follow-up of 21.1 years. During the first year of life, prenatal exposure to maternal smoking is correlated with an improved rate of fracture but does not appear to have a long-lasting biological impact on fractures later in childhood and up to early adulthood.