Maternal Smoking, Urinary Cotinine Levels and Birth‐Weight

Mathai, Matthews; Skinner, Andrew C.; Lawton, K.; Weindling, A M

doi:10.1111/j.1479-828x.1990.tb03192.x

Cited by 45 publications

(24 citation statements)

References 14 publications

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“…This observation has implications for the use of cotinine as a biomarker for cigarette smoking during pregnancy. Our data do not affect the validity of cotinine levels as a predictor of pregnancy outcomes, which are based on empirical observations (Mathai et al, 1990;Bardy et al, 1993;Li et al, 1993;Ellard et al, 1996). But our study does indicate that the lower cotinine levels observed in smokers during pregnancy compared with the same individuals before or after pregnancy do not necessarily reflect less smoke exposure.…”

Section: Discussionmentioning

confidence: 60%

“…Among pregnant smokers, maternal levels of cotinine correlate better with outcome measures such as birth weight than the number of cigarettes smoked per day (Haddow et al, 1987;Mathai et al, 1990;Bardy et al, 1993;Li et al, 1993;Ellard et al, 1996;Klebanoff et al, 1998;SeckerWalker et al, 1998). Recently, a study of women during pregnancy and again postpartum found that during pregnancy the median saliva cotinine concentration per cigarette was 3.5 ng/ml versus 9.9 ng/ml when not pregnant (Rebagliato et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

“…Plasma or saliva cotinine levels are reported to be lower in pregnant smokers compared with nonpregnant women (Mathai et al, 1990;Rebagliato et al, 1998;Ogburn et al, 1999). The use of a biomarker to quantitate exposures requires an understanding of its disposition kinetics in different conditions (Benowitz, 1999).…”

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confidence: 99%

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Accelerated Metabolism of Nicotine and Cotinine in Pregnant Smokers

Dempsey

Jacob²,

Benowitz³

2002

J Pharmacol Exp Ther

406

307

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Cigarette smoking is the foremost modifiable risk factor for adverse pregnancy outcomes. Nicotine is a suspected fetal neuroteratogen. There is concern that nicotine may achieve toxic levels during pregnancy if nicotine replacement therapies are prescribed at doses used in the nonpregnant state. Ten healthy, volunteer, pregnant smokers received infusions of deuterium-labeled nicotine and cotinine during pregnancy and again postpartum. From blood and urine measurements, the following were determined: clearance (renal and nonrenal) of nicotine and cotinine, clearance of nicotine via the cotinine pathway (an indicator of CYP2A6 activity), and daily intake of nicotine from smoking. The clearance of nicotine and cotinine was significantly higher (60 and 140%, respectively), and the half-life of cotinine was much shorter (8.8 versus 16.6 h, P Ͻ 0.01) during pregnancy. Although plasma levels of cotinine were lower during pregnancy (119 versus 202 ng/ml, P Ͻ 0.05), daily intake of nicotine from smoking was similar during pregnancy and postpartum. For a given level of intake, the pharmacologic and toxicologic effects of nicotine during pregnancy are anticipated to be less than expected from nicotine metabolism data in nonpregnant women. Our data indicate that no downward dose adjustment needs to be made for nicotine replacement therapy during pregnancy. Conversely, higher than usual doses of nicotine may be necessary to optimize efficacy. Lower cotinine levels observed during pregnancy do not necessarily reflect less smoke exposure, and cut-off levels used to classify nonsmokers, passive smokers, and active smokers need to be established for pregnancy.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

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Accelerated Metabolism of Nicotine and Cotinine in Pregnant Smokers

Dempsey

Jacob²,

Benowitz³

2002

J Pharmacol Exp Ther

406

307

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“…6 This, and a number of studies, have found a closer dose -e¡ect relationship between birthweight de¢cits and nicotine metabolite levels in serum and urine than with self-reported cigarette consumption. 7,8 Serum cotinine concentration at 16 weeks'gestation was also found to have a high positive predictive value for small-for-gestational age deliveries, which was double that for self-reported smoking habit and independent of associated maternal characteristics. 9 This led to the recommendation that Original Article biochemical veri¢cation of self-reported quitting is essential to the evaluation of smoking cessation interventions and may be a useful predictor of poor pregnancy outcome.…”

Section: Introductionmentioning

confidence: 88%

Feedback from a point-of-care test for nicotine intake to reduce smoking during pregnancy

2003

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“…In the first reports, exposure assessment was based only on information on the spouse's smoking (5)(6)(7)9,(11)(12)(13)(15)(16)(17)21,22,24,26). Later studies collected information on multiple sources, such as other family members and work exposure or on quantity measured as daily duration of exposure or number of cigarettes smoked indoors (10,(18)(19)(20)25,31).…”

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confidence: 99%

Fetal Growth and Length of Gestation in Relation to Prenatal Exposure to Environmental Tobacco Smoke Assessed by Hair Nicotine Concentration

Jaakkola¹,

Jaakkola²,

Zahlsen³

2001

Environmental Health Perspectives

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The adverse effects of maternal smoking during pregnancy on fetal growth (1,2), as well as on the risk of preterm delivery (3) are well established. People exposed to environmental tobacco smoke (ETS) encounter mainly the same compounds as in the mainstream smoke inhaled directly by the smoker, although the concentrations and time patterns differ (2,4). Although individual studies have often been inconclusive (5-31), a recent meta-analysis by Windham and colleagues (32) suggests that exposure to ETS during pregnancy has a small effect on birth weight and the risk of term low birth weight. The effects on the length of gestation and risk of preterm delivery have been studied less (10,19,23,25), and the evidence of any effect is weak.Assessment of exposure during a relevant time period and control of confounding are the most critical issues of validity in studies of the effects of ETS on pregnancy outcomes (32,33). In the first reports, exposure assessment was based only on information on the spouse's smoking (5)(6)(7)9,(11)(12)(13)(15)(16)(17)21,22,24,26). Later studies collected information on multiple sources, such as other family members and work exposure or on quantity measured as daily duration of exposure or number of cigarettes smoked indoors (10,(18)(19)(20)25,31). Questionnaire or interview information on sources of exposure is sensitive to information bias, especially if carried out after the delivery and if the accuracy of the smoking information is compromised due to inaccurate recall and variation of environmental conditions such as air change, area, and volume of the space. Few studies have used biomarkers of exposure such as serum cotinine (14,28,30) and saliva cotinine (29) measured during pregnancy or after delivery. Both of these biomarkers share a common feature of having a short half-life (4), and therefore they measure exposure only during a couple of days before sampling. Hair nicotine is a new promising biomarker; the method is noninvasive, and a sample of 0-2 cm from the proximal hair gives a good estimate of the exposure during the past 2 months (34,35). Taking into account the time frame, a hair sample at birth would describe exposure during the last trimester, which is considered the most important period for fetal growth. In a recent case-control study by Nafstad and colleagues (36), the risk of small-for-gestationalage births was related to the hair nicotine concentration of newborns and of their nonsmoking mothers after the delivery. We further studied the relation between exposure to ETS measured as maternal hair nicotine concentration after delivery and the risk of being small for gestational age. With the present study design, we were also able to study the effects on birth weight and the risks of low birth weight and preterm delivery. We also assessed the relations between hair nicotine concentration and reported exposure to ETS. Methods Study population. The Finnish PrenatalEnvironment and Health Study focused on a source population that included all the 2,751 children born from...

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Maternal Smoking, Urinary Cotinine Levels and Birth‐Weight

Cited by 45 publications

References 14 publications

Accelerated Metabolism of Nicotine and Cotinine in Pregnant Smokers

Accelerated Metabolism of Nicotine and Cotinine in Pregnant Smokers

Feedback from a point-of-care test for nicotine intake to reduce smoking during pregnancy

Fetal Growth and Length of Gestation in Relation to Prenatal Exposure to Environmental Tobacco Smoke Assessed by Hair Nicotine Concentration

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