[What diagnostic tools can be used to assess antenatal exposure to smoking? Toxicologist experience]

Based on a review of the literature and our toxicological experience, we present the diagnostic tools available for the clinician to explore and quantify the degree of ante-natal exposure to active and passive maternal smoking. Two types of tools are used to evaluate this fetal exposure:--Repeated measurement of bio-markers of tobacco smoking enable and evaluation of the specific degree of nicotinic exposure for the pregnant women, the fetus (cord blood), the placenta and the newborn. The total fetal exposure during pregnancy can be extrapolated by combining these data. --Markers of toxicity related to active and passive maternal smoking (cadmium, cytochrome P450 CYP 1A1 activity). In the newborn, two biological tissues, meconium and hair, can be used to obtain an objective measurement of fetal exposure. Meconium concentrations of cotinine and trans-3'-hydroxycotinine correctly reflect the nicotinic practices of the mother and neonatal hair concentrations of nicotine and cotinine confirm the systemic degree of long-term exposure.