Fetal Exposure to Carcinogens with Tobacco Use in Pregnancy: Phase 1 MAW Study Findings (original) (raw)
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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.
Environmental Research, 2002
The risk of delivering a low-birth-weight infant as the result of exposing a nonsmoking pregnant woman to environmental tobacco smoke (ETS) is not well deAned. The method of ascertaining ETS exposure during pregnancy may explain the lack of consistent study Andings. In a large sample of pregnant women, we compared distributions between two methods of ETS exposure: self-report and cotinine, a nicotine metabolite, from serum. At delivery, subjects were asked about duration and location of exposure to ETS during their second trimester. A single cotinine measurement was assayed from serum collected at 15+19 weeks gestation (limit of detection ؍ 0.05 ng/mL). Self-reported (hours per day) ETS exposure was correlated (r ؍ 0.38) with cotinine concentration. Regression analysis revealed that while self-reported ETS was signiAcantly associated with (log) cotinine, it did not explain a large amount of total variation. While 72% of subjects reported no exposure to ETS, almost all had measurable levels of cotinine. Studies of pregnant women based upon an hours per day ETS question have likely misclassiAed a sizable portion of ETS-exposed women as ''unexposed.'' Since there is recent evidence that low levels of ETS exposure result in unfavorable pregnancy outcomes, these studies have underestimated the effect of ETS.
Exposure to tobacco smoke and validation of smoking status during pregnancy in the MIREC study
Journal of exposure science & environmental epidemiology, 2018
Given that prenatal exposure to tobacco smoke can lead to increased risks of adverse health effects, having valid measures of exposure is important. In a Canadian cohort (n = 2000), maternal and infant biospecimens were analysed for cotinine. Sensitivity and specificity of self-reported active smoking status were estimated. Regression modelling was used to identify potential predictors of maternal and infant plasma cotinine in non-smoking women. During the first trimester, 60.6% of the women reported never smoking, 27.3% were former smokers, 6.1% had quit when they found out they were pregnant, 5.8% were smokers and 42% of the non-smokers reported exposure to secondhand smoke (SHS). Low detection of tobacco biomarkers in meconium limited its ability to identify exposure to SHS. The sensitivity and specificity for self-reported smoking during the 1st trimester were 85.37 and 99.45%, respectively. The lowest sensitivity was found in participants with the highest level of education and...
Reproducibility of Reported In Utero Exposure to Tobacco Smoke
Annals of Epidemiology, 2011
PURPOSE-In studies of the fetal origins of disease and life course epidemiology, measures of fetal exposure may be based on information reported by the adults who were exposed in utero. In particular, the full spectrum of consequences of in utero exposure to maternal tobacco smoking is now an area of active investigation, and the ability to report such exposure reproducibly is of interest. We evaluated the reproducibility of in utero exposure to tobacco smoke, reported by the adult daughter during consecutive pregnancies.
Exposure to Tobacco Smoke in Utero and the Risk of Stillbirth and Death in the First Year of Life
American Journal of Epidemiology, 2001
The authors examined the association between exposure to tobacco smoke in utero and the risk of stillbirth and infant death in a cohort of 25,102 singleton children of pregnant women scheduled to deliver at Exposure to tobacco smoke in utero was associated with an increased risk of stillbirth (odds ratio = 2.0, 95% confidence interval: 1.4, 2.9), and infant mortality was almost doubled in children born to women who had smoked during pregnancy compared with children of nonsmokers (odds ratio = 1.8, 95% confidence interval: 1.3, 2.6). Among children of women who stopped smoking during the first trimester, stillbirth and infant mortality was comparable with that in children of women who had been nonsmokers from the beginning of pregnancy. Conclusions were not changed after adjustment in a logistic regression model for the sex of the child; parity; or maternal age, height, weight, marital status, years of education, occupational status, and alcohol and caffeine intake during pregnancy. Approximately 25% of all stillbirths and 20% of all infant deaths in a population with 30% pregnant smokers could be avoided if all pregnant smokers stopped smoking by the sixteenth week of gestation. Am J Epidemiol 2001;154:322-7.
Prenatal and postnatal environmental tobacco smoke exposure and children's health
Pediatrics, 2004
Children's exposure to tobacco constituents during fetal development and via environmental tobacco smoke (ETS) exposure is perhaps the most ubiquitous and hazardous of children's environmental exposures. A large literature links both prenatal maternal smoking and children's ETS exposure to decreased lung growth and increased rates of respiratory tract infections, otitis media, and childhood asthma, with the severity of these problems increasing with increased exposure. Sudden infant death syndrome, behavioral problems, neurocognitive decrements, and increased rates of adolescent smoking also are associated with such exposures. Studies of each of these problems suggest independent effects of both pre- and postnatal exposure for each, with the respiratory risk associated with parental smoking seeming to be greatest during fetal development and the first several years of life.