Browsing by Author "Camelo, Alexandra"
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- Biomarker-validated maternal smoking and environmental tobacco smoke exposure status and its associations with perinatal outcomesPublication . Silva, Ana Inês; Camelo, Alexandra; Madureira, Joana; Reis, Ana Teresa; Barbosa, Fernando; Teixeira, João Paulo; Costa, CarlaTobacco consumption and environmental tobacco smoke (ETS) are associated with an increased risk of multiple adverse perinatal outcomes. Within the framework of the NEOGENE project, the aim of this study was to validate smoking and ETS exposure status among pregnant women, to more precisely ascertain its associations with perinatal outcomes, using urinary cotinine (UC), a biomarker of tobacco smoke exposure. (...)
- Caracterização da exposição ao tabaco durante a gravidez e da sua influência em indicadores de saúde neonatal: projeto NeoGenePublication . Madureira, Joana; Silva, Ana Inês; Camelo, Alexandra; Reis, Ana Teresa; Machado, Ana Paula; Ribeiro, Ana Isabel; Teixeira, João Paulo; Costa, CarlaO tabagismo e a exposição ao fumo ambiental do tabaco (ou exposição passiva) estão associados a vários efeitos adversos na saúde, particularmente em períodos de maior suscetibilidade como o período pré-natal. Como condição essencial para o delineamento de estratégias mais adequadas e efetivas de promoção de saúde e prevenção de doença associadas, torna-se essencial caracterizar detalhadamente a exposição ao tabaco no início da vida e conhecer a sua influência em diferentes indicadores de saúde neonatal. Para tal, foi analisada informação individual e clínica de 595 grávidas com mais de 36 semanas de gestação, em consulta no Serviço de Obstetrícia e Ginecologia do Centro Hospitalar de S. João, entre abril de 2017 e julho de 2018. Foram também analisados indicadores de saúde neonatais dos respetivos recém-nascidos por consulta dos seus processos clínicos. Os resultados deste estudo mostram uma prevalência do consumo do tabaco de 27,9% antes da gravidez, valor que diminui para 12,9% ao nascimento, como resultado de uma cessação tabágica de 46,4% durante a gestação. Em termos de exposição passiva ao fumo do tabaco, verificou-se que 31,7% das participantes não fumadoras estavam diariamente expostas, durante mais de uma hora, antes da gravidez, e que houve uma diminuição da exposição ao longo da gravidez (26,3% no terceiro trimestre). A análise da associação entre os indicadores de saúde neonatal e os comportamentos tabágicos apontam para uma diminuição do peso, tamanho e perímetro cefálico ao nascimento entre os recém-nascidos das participantes fumadoras, valores que aumentam nos casos em que há cessação tabágica durante a gravidez
- Maternal tobacco smoke exposure and determination of the optimal urinary cotinine cut-off values: a cross-sectional birth studyPublication . Silva, AI; Camelo, Alexandra; Madureira, Joana; Reis, Ana Teresa; Barbosa, Fernando Jr; Teixeira, J,P,; Costa, CarlaWithin the frame of the NEOGENE project, the aim of this study was to identify the optimal UC cut-off values to discriminate smoking and ETS exposure status and to assess the validity of self-reported smoking and ETS exposure status using urinary cotinine (UC) as a biomarker.
- The importance of smoking cessation during pregnancy and its association with perinatal outcomesPublication . Silva, Ana Inês; Camelo, Alexandra; Madureira, Joana; Reis, Ana Teresa; Barbosa Jr, Fernando; Teixeira, João Paulo; Costa, CarlaIn utero exposure to tobacco smoke is associated with an increased risk of multiple adverse perinatal outcomes. Smoking cessation during pregnancy has been related to the improvement of these outcomes, but often relies on self-reporting, impairing an accurate assessment of smoking cessation impact on newborńs health. Building on data obtained in the frame of the NEOGENE project, this work aimed to estimate the association between smoking cessation among pregnant women, confirmed by maternal urinary cotinine concentrations, and perinatal outcomes. The study population included 595 pregnant women who sought prenatal care in a public hospital in Porto (Portugal), from April 2017 to July 2018. Data on tobacco consumption and cessation was obtained in a face-to-face interview, during the hospital stay. Perinatal outcomes, namely birth weight (BW), length (BL) and head circumference (HC) were retrieved from the hospital medical records. Maternal self-reported tobacco use was validated by urinary cotinine concentrations, using the solid-phase competitive ELISA technique. Maternal active smoking was associated with a significant decrease in BW, BL and HC of 157.66 g (p < 0.001), 0.78 cm (p = 0.001) and 0.39 cm (p = 0.016). Notably, maternal smoking cessation led to a significant increase in BW of approximately 172 g (p = 0.006), when compared to mothers who have not ceased. Increases in BL and HC did not reach significance. This study upholds that tobacco consumption is still an important public health threat in Portugal and that smoking cessation during pregnancy reverses smoking-associated deficits in perinatal outcomes, emphasizing the crucial need for awareness campaigns to promote smoking cessation during pregnancy.
- The importance of socioeconomic position in smoking, cessation and environmental tobacco smoke exposure during pregnancyPublication . Madureira, Joana; Camelo, Alexandra; Silva, Ana Inês; Reis, Ana Teresa; Esteves, Filipa; Ribeiro, Ana Isabel; Teixeira, João Paulo; Costa, CarlaTobacco is still a leading cause of premature death and morbidity. Particular attention has been given to pregnant women due to the scientific evidence on the importance of early life exposures for disease onset later in life. The purpose of this study was to assess smoking prevalence, smoking cessation rate and environmental tobacco smoke (ETS) exposure, and the role of socioeconomic position (SEP) on these behaviors among pregnant women. Cross-sectional data of 619 pregnant women, aged between 18 and 46 years, from Porto Metropolitan Area, Portugal, on current smoking, ETS exposure and SEP indicators was collected, face-to-face, using a questionnaire filled in during a personal interview at the postpartum hospital stay. The smoking prevalence, and ETS exposure among non-smokers before pregnancy was 27.6% and 57.4%, respectively. 4.1% of the participants reported to have stopped smoking before pregnancy, whereas about 41% quitted along pregnancy, resulting in a smoking prevalence at birth of 14.6%. Exposure to ETS also decreased throughout pregnancy to 49.8% at birth. Lower educational level was significantly associated with both higher smoking prevalence and exposure to ETS and lower smoking cessation. This study demonstrates that smoking and ETS exposure during pregnancy remains high, and that there are still significant socioeconomic inequalities in smoking; thus tobacco-focused preventive interventions need to be reinforced.
- Urinary cotinine assessment of maternal smoking and environmental tobacco smoke exposure status and its associations with perinatal outcomes: a cross-sectional birth studyPublication . Silva, Ana Inês; Camelo, Alexandra; Madureira, Joana; Reis, Ana Teresa; Machado, Ana Paula; Teixeira, João Paulo; Costa, CarlaAbstract: Tobacco consumption and environmental tobacco smoke (ETS) exposure remains an important public health concern. Pregnant women require particular attention as active and passive smoking during pregnancy are associated with multiple adverse perinatal outcomes. This study aimed to biochemically validate self-reported smoking and ETS exposure status among pregnant women, to more precisely ascertain its association with adverse perinatal outcomes. Data refers to 595 pregnant women who sought prenatal care in a public hospital in Porto, Portugal. A standard questionnaire on smoking and ETS-related variables was completed. Urinary cotinine (UC) concentrations were assessed by solid-phase competitive ELISA, in maternal urine samples collected on the day of delivery. The results showed that the optimal UC cut-off value to distinguish smokers from non-smokers and within non-smokers those who were exposed to ETS from those non-exposed in the third trimester of pregnancy was 74.1 ng/mL (sensitivity and specificity of 96.7% and 98.0%, respectively) and 1.6 ng/mL (sensitivity of 66.2% and specificity of 75.7%, respectively). The agreement between maternal self-reported and UC-based smoking status was very good (κ=0.919, p<0.001), but much lower for ETS exposure (κ=0.386, p<0.001). Maternal active smoking in the third trimester of pregnancy was associated with a significant decrease in birth weight, length and head circumference of 157.66 g (95% CI: −245.81, −69.52; p<0.001), 0.78 cm (95% CI: −1.22, −0.34; p=0.001) and 0.39 cm (95% CI: −0.70, −0.07; p=0.016), respectively. Maternal ETS exposure in the third trimester of pregnancy was associated with a non-significant increase in birth weight of 38.37 g (95% CI: −28.91, 105.64; p=0.263). Furthermore, maternal smoking cessation was associated with the increase of approximately 172 g in birth weight (95% CI: 50.00, 293.19). As such, there is an urgent need for increased public health awareness campaigns to encourage smoking cessation during pregnancy, in order to improve perinatal outcomes.