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Simultaneous fetal and maternal cotinine levels in pregnant women smokers
A E Donnenfeld1, A Pulkkinen, G E Palomaki
1Department of Obstetrics and Gynecology, Pennsylvania Hospital, Philadelphia 19107.
Objective:
Our purpose was to determine the simultaneous concentrations of serum cotinine in both fetal and maternal blood.
Study Design:
Serum cotinine levels were measured in 11 maternal-fetal pairs at percutaneous umbilical blood sampling. Statistical analysis was performed by means of a one-group t test to determine whether the ratio of fetal-to-maternal cotinine was significantly different from 1.
Results:
Fetal cotinine levels ranged from 75% to 110% of maternal values (mean ratio 0.90, 95% confidence interval 0.83 to 0.97). Fetal levels were significantly lower than maternal concentrations (p = 0.02).
Conclusions:
Cotinine, a metabolite of nicotine used to quantify exposure to tobacco smoke, readily gains access to the fetal circulation. Fetal cotinine concentrations in pregnant women smokers are, on average, 90% of maternal values throughout gestation.