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Updated: May 14, 2026
Semiconductor Sequencing for Preimplantation Genetic Testing for Aneuploidy
Published on: August 25, 2019
Accuracy of self-reported smoking status in first trimester aneuploidy screening
Kevin Spencer1, Nicholas J Cowans
1Prenatal Research Unit, Department of Clinical Biochemistry, King George Hospital, Barley Lane, Goodmayes, IG3 8YB, UK. KevinSpencer1@aol.com
Objectives:
To review the accuracy of self-reporting of smoking status in our first trimester screening population and to assess the levels of pregnancy-associated plasma protein-A (PAPP-A) and free-β human chorionic gonadotropin (free-hCGβ) in women who were classified for smoking status by serum cotinine concentrations and self-reporting.
Methods:
Cotinine concentration was determined in the stored serum 696 self-reported smokers and 442 self-reported non-smokers. PAPP-A and free-hCGβ multiples of the medians (MoMs) determined at screening were reverted to uncorrected for self-reported smoking status.
Results:
A total of 21.7% of those self-reporting as non-smokers had increased serum cotinine concentrations (using a cut-off of 13.7 ng/mL), indicating a positive smoking status. This under-reporting meant that serum PAPP-A and free-hCGβ MoMs were greater reduced in smokers classified by cotinine levels (17.2% and 9.7%) than in those classified by self-reporting (14.6% and 2.8%). Women who were classified as smokers at conception but had stopped at some time afterwards did not have significantly reduced marker MoMs to non-smokers.
Conclusions:
Self-reporting results in under-representation of smoking in our population, resulting in a significant bias and inflated screen-positive rates.
