Assessment of prenatal exposure to tobacco smoke by cotinine in cord blood for the evaluation of smoking control policies in Spain (original) (raw)
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Journal of Clinical and Translational Research, 2022
Background: Tobacco use is one of the most important causes of obstetric and perinatal pathologies. Its frequency during pregnancy is high and could be related to various socioeconomic and cultural characteristics of the mothers. Aim: The aim of this study is to determine the trend and prevalence of smoking in pregnant mothers in our area over the years and the socio-cultural or obstetric factors associated with smoking as well as the repercussions on the newborns related to its consumption. Methods: Retrospective study of 18,959 mothers of healthy newborns in the maternity ward of the regional hospital during the years 2002–2019. The variable under study was maternal smoking during pregnancy compared with various maternal, obstetric, and perinatal factors. Results: A mean percentage of 20.4% of the mothers smoked, with significantly decreasing percentages over the years. There was a significant association between smoking and mothers’ age, origin, level of education, the occurrence...
BJOG: An International Journal of Obstetrics and Gynaecology, 1993
Objectives To measure quantitatively and objectively the maternal and fetal tobacco exposure during pregnancy and its neonatal effects. Design Tobacco exposure was assessed from maternal serum samples, obtained during the first half of pregnancy and from umbilical serum samples obtained at delivery, by measuring the concentration of nicotine metabolite, cotinine. Data on the respective pregnancies and neonates were collected from the Finnish Medical Birth Registry. Setting Finland. Subjects One thousand two hundred and thirty-seven pregnancies and newborns, representing all preg-Main outcome measures Gestational age, birthweight and crown-heel length of newborns. Results Cotinine (>6 pg/l) was detected in either maternal or umbilical serum in 300 pregnancies, and these mothers and newborns were classified as exposed. Important differences occurred between measured exposure and reported smoking behaviour. Of the exposed mothers, 38% were nonsmokers and 3.4% of the nonexposed mothers were smokers. Tobacco exposure was associated with shorter gestational age, reduced birthweight and shorter crown-heel length of the newborns. After correction for parity, gender, and gestational age, the exposed newborns were on average 188 g (95% confidence interval (C1) 123-253 g) lighter and 10 mm (95% CI 7-13 mm) shorter than the nonexposed newborns. One pg/ml of cotinine in maternal serum resulted in a mean decrease of 1.29 g (95% CI 0.55-2-02 g) in birthweight and in a mean decrease of 0.059 mm (95% CI 0.0354083 mm) in birth length. Maternal cotinine concentrations better explained the neonatal findings than the reported smoking habits. Conclusions There is a quantitative dose and effect relation between tobacco exposure and a decrease in the gestational age at birth and size of the neonate. The smoking habit reported by mothers themselves is not an accurate measure of fetal tobacco exposure.
Science of the Total Environment, 2014
Objectives. To examine the association of social and environmental factors with levels of second-hand smoke (SHS) exposure, as measured by salivary cotinine, in young inner-city children with asthma. Methods. We used data drawn from a home-based behavioral intervention for young high-risk children with persistent asthma post-emergency department (ED) treatment (N = 198). SHS exposure was measured by salivary cotinine and caregiver reports. Caregiver demographic and psychological functioning, household smoking behavior, and asthma morbidity were compared with child cotinine concentrations. Chi-square and ANOVA tests and multivariate regression models were used to determine the association of cotinine concentrations with household smoking behavior and asthma morbidity. Results. Over half (53%) of the children had cotinine levels compatible with SHS exposure and mean cotinine concentrations were high at 2.42 ng/ml (SD 3.2). The caregiver was the predominant smoker in the home (57%) and 63% reported a total home smoking ban. Preschool aged children and those with caregivers reporting depressive symptoms and high stress had higher cotinine concentrations than their counterparts. Among children living in a home with a total home smoking ban, younger children had significantly higher mean cotinine concentrations than older children (cotinine: 3-5 year olds, 2.24 ng/ml (SD 3.5); 6-10 year olds, 0.63 ng/ml (SD 1.0); p < .05). In multivariate models, the factors most strongly associated with high child cotinine concentrations were increased number of household smokers (β = 0.24) and younger child age (3-5 years) (β = 0.23; p < .001, R 2 = 0.35). Conclusion. Over half of the young inner-city children with asthma were exposed to SHS, and caregivers are the predominant household smokers. Younger children and children with depressed and stressed caregivers are at significant risk of smoke exposures, even when a household smoking ban is reported. Further advocacy for these high-risk children is needed to help caregivers quit and to mitigate smoke exposure.
An Epidemiologic Study Comparing Fetal Exposure to Tobacco Smoke in Three Southeast Asian Countries
International Journal of Occupational and Environmental Health, 2008
The high prevalence of smoking in Southeast Asia (SEA) means pregnant women face exposure to tobacco smoke that may affect the health of their fetus. This study determined fetal exposure to tobacco smoke by meconium analysis for cotinine in 3 locations in SEA: Bulacan Province, Philippines (N=316), Bangkok, Thailand (N=106) and Singapore City (N=61). Maternal exposure to tobacco smoke was 71.1% (1.3% active; 69.8% passive) in Bulacan, 57.5% (0.9% active; 58.6% passive) in Bangkok and 54.1% (11.5% active; 42.0% passive) in Singapore. Fetal exposure to tobacco smoke (by meconium analysis) was 1.3% (Bulacan), 4.7% (Bangkok) and 13.1% (Singapore); however, a large proportion of infants who tested positive for cotinine (65%) were born to mothers who gave no history of either active or passive exposure to environmental tobacco smoke. Fetal exposure to tobacco smoke is a major health problem.
2003
Objective: to evaluate the consequences of maternal smoking Methods: a prospective study of 1.103 pregnant women. A survey in the state Hospital San Martin, de La Plata, Buenos Aires determined general data. Newborn and placenta data were also reported. Mother and child cord samples were obtained to determine blood elements and flow cytometry analysis of lymphocyte subsets performed. Data from smoking (S) and non-smoking (NS) groups were evaluated through relative risk, chi square and Student's t test. Results: of all patients, 887 were NS and 226 said they smoked over five-cigarettes/day (S). The S group showed a higher probability of premature deliveries when compared to the NS group, with newborns weighing under 2,5kg, small in relation to gestational age, with Apgar scores at the 5 th minute under six and hyaline membrane syndrome; intrauterine death risk was higher in this group who attended less medical appointments than scheduled. Umbilical cord blood analysis indicated lower reticulocyte index for S mothers, neutrophil count and CD4/CD8 ratio and increased erythroblast, eosinophil, basophil, total and CD8+T lymphocyte counts. Conclusions: data could explain the observations by other authors related to an increased incidence of allergy and infections in newborns caused by maternal smoking.
Obstetric and perinatal effects of active and/or passive smoking during pregnancy
Sao Paulo Medical Journal, 2004
CONTEXT: Cigarette smoke, whether inhaled voluntarily or not, causes damage to the mother-infant pair. The antenatal period may present the best opportunity for performing effective anti-smoking campaigns. OBJECTIVE: To study the obstetric and perinatal effects of smoking on pregnancy and the infant. TYPE OF STUDY: Prospective study, interviewing pregnant women who were randomly selected at the maternity hospital as they were being discharged after giving birth. SETTING: Hospital Municipal Vereador José Storópolli, São Paulo, Brazil. METHODS: 758 patients were interviewed regarding smoke inhalation before being discharged from the maternity hospital. The groups were formed by 42 active smokers, 272 passive smokers, 108 who inhaled smoke both actively and passively, and 336 non-smokers. The groups were compared regarding age, parity, school education, incidence of spontaneous abortion, rate of caesarian births, average gestational age at birth, rate of low birth weight and adequacy of weight in relation to the gestational age of newborn infants. For all variables we considered p < 0.05 as statistically significant. RESULTS: There was a high rate (55.7%) of pregnant smokers, including 5.5% active, 35.9% passive and 14.3% active-passive smokers. Active and active-passive smokers were older and had higher parity. Active smokers had lower education levels and higher rates of previous spontaneous abortion. The weights of newborn babies were lower for smoking mothers. DISCUSSION: The study was performed among patients that were mostly of low economic, social and cultural levels, thus possibly explaining the high incidence of smokers. Worse still was that 35.9% of the non-smokers were actually passive smokers. These rates we report were similar to those from the literature. The typical receptiveness of teenage girls to unrestricted advertising in the media contributes towards an early start to acquiring the habit of smoking, including during pregnancy in our country. We emphasize the difficulties in quantifying exposure to cigarettes even among active smokers. CONCLUSIONS: Cigarette smoke, whether inhaled voluntarily or not, has an unfavorable effect on the mother-infant pair.
Smoking among pregnant women - epidemiology and health consequences
Smoking during pregnancy is an important, preventable risk factor for late fetal death and even SIDS. There is a strong dose-response relationship between cigarette smoking and spontaneous abortion, reduction in birth weight, abruptio placentae, placenta previa and bleeding during pregnancy. Ten years ago, the prevalence of smoking among Norwegian pregnant women was between 35 and 40%. During the last 8 years there has been a dramatic change and in 1995 the prevalence seems to be around 20%.
Smoking and Pregnancy — A Review on the First Major Environmental Risk Factor of the Unborn
International Journal of Environmental Research and Public Health, 2013
Smoking cigarettes throughout pregnancy is one of the single most important avoidable causes of adverse pregnancy outcomes and it represents the first major environmental risk of the unborn. If compared with other risk factors in the perinatal period, exposure to tobacco smoke is considered to be amongst the most harmful and it is associated with high rates of long and short term morbidity and mortality for mother and child. A variety of adverse pregnancy outcomes are linked with cigarette consumption before and during pregnancy. Maternal prenatal cigarette smoke disturbs the equilibrium among the oxidant and antioxidant system, has negative impact on the genetic and cellular level of both mother and fetus and causes a large quantity of diseases in the unborn child. These smoking-induced damages for the unborn offspring manifest themselves at various times in life and for most only a very limited range of causal treatment exists. Education, support and assistance are of high importance to decrease maternal and fetal morbidity and mortality, as there are few other avoidable factors which influence a child's health that profoundly throughout its life. It is imperative that smoking control should be seen as a public health priority.