Association of self‐reported passive smoking in pregnant women with cotinine level of maternal urine and umbilical cord blood at delivery

Abstract

Passive smoking during pregnancy leads to adverse effects on mother and infant. The present investigation was designed to evaluate the association between maternal reported passive smoking with the cotinine concentration of maternal urine and umbilical cord blood at delivery and to determine the accuracy of maternal reporting of exposure to cigarette smoke during pregnancy. This was a cross-sectional study. From the 108 non-smoker pregnant women who were referred for delivery, 54 were passive smokers. Urine samples were collected from the mothers in the delivery room and blood samples after birth were taken from the umbilical cord. Passive smoking was evaluated through questionnaire and cotinine level of urine and umbilical cord blood. The geometric mean cotinine concentration of the maternal urine and the umbilical cord serum were, respectively, 27.4 ± 29.96 ng/mL and 3.71 ± 1.22 ng/mL in the exposed group (P < 0.001) and 0.75 ± 2.29 and 0.40 ± 0.63 in the non-exposed group (P < 0.001). There was a statistically significant correlation between maternal urinary and umbilical cord serum level of cotinine (P < 0.001, r = 0.58). Significant associations were shown between maternal reports of exposure to cigarette smoking with cotinine level of urine (kappa = 96%) and umbilical cord (kappa = 98%) (P < 0.001). This study shows that the pregnant woman's report of passive smoking during pregnancy in Iran is accurate. The questionnaire is an appropriate method to evaluate smoke exposure and could replace cotinine measurement.

Extremely low gestational age and very low birthweight for gestational age are risk factors for autism spectrum disorder in a large cohort study of 10-year-old children born at 23-27 weeks’ gestation

“…Cervical-vaginal ‘infection’ refers to maternal report of bacterial infection (n = 4), bacterial vaginosis (n = 30), yeast infection (n = 62), mixed infection (n = 4) or other/unspecified infection (n=43; e.g., chlamydia, trichomonas or herpes, etc.). Previous research indicates that such information gained through self-report can be more accurate than that obtained from medical records or birth certificates, 14-17 but we do not know the extent to which ‘infection’ per se was confirmed by microbial colonization. The terms ‘fetal growth restriction’ and ‘small for gestational age’ meet our needs equally, and we use them interchangeably since accurate differentiation of pathologically small from constitutionally small newborns (see 18,19 ) is an ongoing challenge.…”

“…24,65,66 We do not know the extent to which maternal reported cervical-vaginal infections involved a documented immune response to microbial colonization (i.e., true infection). Previous research indicates that information gained through self-report during maternal interview can be more accurate than that obtained from medical records or birth certificates, 14-17 though modest reliability has also been reported for some obstetric morbidity surveys. 67,68 In the ELGAN Study, newborns whose mother reported a genitourinary infection during pregnancy were more frequently exposed to inflammation of the chorionic plate, chorion, decidua, fetal stem vessels, and umbilical cord than were those whose mother did not.…”

Antecedents of the Child Behavior Checklist–Dysregulation Profile in Children Born Extremely Preterm

“…53 We included passive smoke exposure, rather than active maternal smoking, in the final multivariable model in light of research suggesting that passive smoke exposure is less often misclassified than active smoking, particularly in pregnant women. 54,55 In high-risk groups, pregnant women frequently under-report harmful exposures. 56 For example, the proportion of pregnant women who denied smoking yet whose cotinine levels were considered characteristic of smokers has sometimes exceeded 20%.…”

The independent effects of second hand smoke exposure and maternal body mass index on the anthropometric measurements of the newborn

“…Another limitation of this study is that the exposure to SHS was based on the women’s self-reporting without the use of a biomarker to verify exposure. This might have skewed our results, considering the high rate of misclassification reported for both active and SHS exposure in pregnancy [25,26]; however such misclassification was not detected, when self-reported SHS was compared to biomarker detected SHS, in some communities in the Middle East [27]. Additionally we did not quantify the exposure to SHS by the number of hours; hence we did not report a dose response relationship between exposure to SHS and pregnancy outcomes; nevertheless due to the self-reporting design of the study and the possibility of recall bias, a dose response might not have been verified.…”