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Serum cotinine concentration and self-reported smoking during pregnancy
M A Klebanoff1, R J Levine, J D Clemens
1Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Instiutes of Health, Bethesda, MD 20892-7510, USA.
American Journal of Epidemiology
|August 5, 1998
Summary
Pregnant women accurately report smoking status, but serum cotinine levels better reflect tobacco exposure than self-reports. This finding is crucial for understanding smoking during pregnancy and its impact on infant health.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Biochemistry
Background:
- Maternal smoking during pregnancy is a significant public health concern.
- Accurate assessment of smoking exposure is vital for understanding adverse pregnancy outcomes.
- Serum cotinine concentration is a biochemical marker of tobacco smoke exposure.
Purpose of the Study:
- To assess the accuracy of self-reported smoking status in pregnant women.
- To compare the accuracy of self-reported smoking versus serum cotinine concentration in estimating tobacco dose.
- To evaluate the correlation between smoking exposure and infant birth weight.
Main Methods:
- Serum cotinine assays were performed on 448 pregnant women from the Collaborative Perinatal Project (1959-1966).
- Self-reported smoking status was compared with cotinine levels (>10 ng/ml indicating active smoking).
- Correlation coefficients were calculated between cotinine levels, self-reported smoking, and infant birth weight.
Main Results:
- 94.9% of non-smokers and 87.0% of smokers accurately reported their smoking status (kappa=0.83).
- A moderate correlation (r=0.44) was observed between cotinine concentration and self-reported cigarettes per day among smokers.
- Serum cotinine concentration showed a stronger correlation with infant birth weight (r=0.246) than self-reported smoking (r=0.200).
Conclusions:
- Pregnant women's self-reports of smoking status are generally accurate.
- Serum cotinine concentration provides a more precise measure of tobacco dose received during pregnancy than self-reporting.
- Biochemical markers like cotinine are valuable for quantifying smoking exposure and its impact on pregnancy outcomes.