Smoking during pregnancy: comparison of self‐reports and cotinine levels in 496 women

Lindqvist, Rune; Lendahls, Lena; Tollbom, ÖRjan; Åberg, H; Håkansson, Anders

doi:10.1034/j.1600-0412.2002.810309.x

Cited by 138 publications

(91 citation statements)

References 18 publications

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“…[53][54][55] Exposure can be assessed with standard questionnaires on smoking, and results can be validated with measurements of serum cotinine levels for a randomly selected group of participants. 56 The second source is breastfeeding. Because of its lipophilic nature, nicotine is readily found in human milk, at concentrations that can be 3 times as high as those in the blood; because nicotine is absorbed orally, the infant of a smoking mother is exposed to significant amounts of nicotine if breastfed.…”

Section: Comprehensive Assessment Of Tobacco Exposurementioning

confidence: 99%

Maternal Smoking and Infantile Gastrointestinal Dysregulation: The Case of Colic

Shenassa¹,

Brown

2004

Pediatrics

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ABSTRACT. Background. Infants' healthy growth and development are predicated, in part, on regular functioning of the gastrointestinal (GI) tract. In the first 6 months of life, infants typically double their birth weights. During this period of intense growth, the GI tract needs to be highly active and to function optimally. Identifying modifiable causes of GI tract dysregulation is important for understanding the pathophysiologic processes of such dysregulation, for identifying effective and efficient interventions, and for developing early prevention and health promotion strategies. One such modifiable cause seems to be maternal smoking, both during and after pregnancy.Purpose. This article brings together information that strongly suggests that infants' exposure to tobacco smoke is linked to elevated blood motilin levels, which in turn are linked to an increased risk of GI dysregulation, including colic and acid reflux. We base this hypothesis on evidence supporting a link between maternal smoking and infantile colic (IC) and on additional evidence proposing increased motilin release, attributable to exposure to tobacco smoke and its metabolites, as a physiologic mechanism linking maternal smoking with infantile GI dysregulation.Methods. We critically review and synthesize epidemiologic, physiologic, and biological evidence pertaining to smoking and colic, smoking and motilin levels, and motilin and colic.Results. Six studies have investigated the link between maternal smoking and IC, but IC was defined according to Wessel's rule of threes (crying for >3 hours per day, >3 days per week, for >3 weeks) in only 1 of these studies. The remaining studies used definitions that ranged from less-stringent variations of Wessel's criteria to definitions that would suggest excessive crying but not necessarily colic. Results from 5 of these studies suggest that there is an independent association between maternal smoking and excessive crying, as well as IC. Recent studies of the GI system provide strong, but indirect, corroborating evidence suggesting physiologic pathways through which maternal smoking can be linked to IC. This physiologic evidence can be outlined as follows: (1) smoking is linked to increased plasma and intestinal motilin levels and (2) higher-than-average levels of motilin are linked to elevated risks of IC. Although these findings from disparate fields suggest a physiologic mechanism linking maternal smoking with IC, the entire chain of events has not been examined in a single cohort. A prospective study, begun in pregnancy and continuing through the first 4 months of life, could provide definitive evidence linking these disparate lines of research. Key points for such a study are considered.Conclusions. New epidemiologic evidence suggests that exposure to cigarette smoke and its metabolites may be linked to IC. Moreover, studies of the GI system provide corroborating evidence that suggests that (1) smoking is linked to increased plasma and intestinal motilin levels and (2) higher-than-average intesti...

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Section: Comprehensive Assessment Of Tobacco Exposurementioning

confidence: 99%

Maternal Smoking and Infantile Gastrointestinal Dysregulation: The Case of Colic

Shenassa¹,

Brown

2004

Pediatrics

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“…[22][23][24][25][26] Studies conducted in Australia and elsewhere using biochemical testing to validate self-reporting of smoking status have reported that between 6% and 39% of smoking women do not disclose their smoking status. [27][28][29][30][31] Greater levels of non-disclosure are found in women who are older, married and have higher socioeconomic status. 23,26,27 As a result, the true prevalence of maternal smoking is likely to be under-estimated and opportunities for smoking cessation interventions could be missed.…”

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confidence: 99%

Linking birth records to hospital admission records enhances the identification of women who smoke during pregnancy

Tran

Roberts

Havard

et al. 2014

Australian and New Zealand Journal of Public Health

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Objective: Birth records and hospital admission records are valuable for research on maternal smoking, but individually are known to under-estimate smokers. This study investigated the extent to which combining data from these records enhances the identification of pregnant smokers, and whether this affects research findings such as estimates of maternal smoking prevalence and risk of adverse pregnancy outcomes associated with smoking. Methods:A total of 846,039 birth records in New South Wales, Australia, (2001Australia, ( -2010 were linked to hospital admission records (delivery and antenatal). Algorithm 1 combined data from birth and delivery admission records, whereas algorithm 2 combined data from birth record, delivery and antenatal admission records. Associations between smoking and placental abruption, preterm birth, stillbirth, and low birthweight were assessed using multivariable logistic regression.Results: Algorithm 1 identified 127,612 smokers (smoking prevalence 15.1%), which was a 9.6% and 54.6% increase over the unenhanced identification from birth records alone (prevalence 13.8%), and delivery admission records alone (prevalence 9.8%), respectively. Algorithm 2 identified a further 2,408 smokers from antenatal admission records. The enhancement varied by maternal socio-demographic characteristics (age, marital status, country of birth, socioeconomic status); obstetric factors (multi-fetal pregnancy, diabetes, hypertension); and maternity hospital. Enhanced and unenhanced identification methods yielded similar odds ratios for placental abruption, preterm birth, stillbirth and low birthweight. Conclusions:Use of linked data improved the identification of pregnant smokers. Studies relying on a single data source should adjust for the under-ascertainment of smokers among certain obstetric populations.

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“…A concentration of 15 ng/mL in saliva or serum is a conservative cut point for detecting active smoking (2,3). Using cotinine to check smoking status, there is evidence that self-report is unreliable in specific populations where there is pressure not to admit smoking, such as patients with respiratory illness (4,5) or cancer (6) or pregnant women (7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Can We Trust National Smoking Prevalence Figures? Discrepancies Between Biochemically Assessed and Self-Reported Smoking Rates in Three Countries

West

Zatoński

Przewoźniak

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

128

100

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Background: National smoking prevalence estimates are the primary basis for assessing progress in tobacco control across the world. They are based on surveys of self-reported cigarette smoking. It has been assumed that this is sufficiently accurate for policy purposes, but this assumption has not been adequately tested. Methods: We report data from the 2003 Health Survey for England, the U.S. National Health and Nutrition Examination Survey for [2001][2002], and the 2004 national smoking behaviors survey in Poland as examples of countries at different stages in the ''tobacco epidemic.'' Self-reported cigarette and total tobacco smoking prevalence were assessed by means of the standard questions used in each country. In subsamples, specimens were collected for analysis of cotinine (saliva, N = 1,613 in England; serum, N = 4,687 in the

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Smoking during pregnancy: comparison of self‐reports and cotinine levels in 496 women

Abstract: If the true facts about exposure to tobacco smoke are not revealed, a number of women who might benefit from information and support at the antenatal clinic will miss the opportunity of such assistance, resulting in increased risks for both the woman and her fetus.

Cited by 138 publications

References 18 publications

Maternal Smoking and Infantile Gastrointestinal Dysregulation: The Case of Colic

Maternal Smoking and Infantile Gastrointestinal Dysregulation: The Case of Colic

Linking birth records to hospital admission records enhances the identification of women who smoke during pregnancy

Can We Trust National Smoking Prevalence Figures? Discrepancies Between Biochemically Assessed and Self-Reported Smoking Rates in Three Countries

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