Tobacco smoke and its metabolites, especially nicotine, have an irritant, genotoxic, mutagenic, teratogenic, cancerigenic and psychoactive effect. Smoking during pregnancy is considered an antepartal (maternal) cause of fetal hypoxemia, i.e. fetoplacental respiratory insufficiency. Carboxyhemoglobinaemia and chronic hypoxemia, impairment of chorionic histoarchitectonic and placentation, vasoconstriction of uteroplacental circulation and intermediary metabolism disturbance are the etiopathogenetic basis of intrauterine fetal growth retardation, i.e. fetal smoking syndrome.