Effects of in utero exposure to environmental contaminants: an epigenetic approach

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Assessment of indoor air exposure at residential homes: Inhalation dose and lung deposition of PM10, PM2.5 and ultrafine particles among newborn children and their mothers

Publication . Madureira, Joana; Slezakova, Klara; Silva, Ana Inês; Lage, Bruna; Mendes, Ana; Aguiar, Lívia; Pereira, Maria Carmo; Teixeira, João Paulo; Costa, Carla

Accurate assessment of particulate matter (PM) dose and respiratory deposition is essential to better understand the risks of exposure to PM and, consequently, to develop the respective risk-control strategies. In homes, this is especially relevant in regards to ultrafine particles (UFP; <0.1 μm) which origin in these environments is mostly due to indoor sources. Thus, this study aimed to estimate inhalation doses for different PM mass/number size fractions (i.e., PM10, PM2.5 and UFP) in indoor air of residential homes and to quantify the deposition (total, regional and lobar) in human respiratory tract for both newborn children and mothers. Indoor real-time measurements of PM10, PM2.5 and UFP were conducted in 65 residential homes situated in Oporto metropolitan area (Portugal). Inhalation doses were estimated based on the physical characteristics of individual subjects and their activity patterns. The multi-path particle dosimetry model was used to quantify age-specific depositions in human respiratory tract. The results showed that 3-month old infants exhibited 4-fold higher inhalation doses than their mothers. PM10 were primarily deposited in the head region (87%), while PM2.5 and UFP depositions mainly occurred in the pulmonary area (39% and 43%, respectively). Subject age affected the pulmonary region and the total lung deposition; higher deposition being observed among the newborns. Similarly, lower lobes (left lobe: 37% and right lobe: 30%) received higher PM deposition than upper and middle lobes; right lobes lung are prone to be more susceptible to respiratory problems, since asymmetric deposition was observed. Considering that PM-related diseases occur at specific sites of respiratory system, quantification of site-specific particle deposition should be predicted in order to better evidence the respective health outcomes resulting from inhaled PM.

2020-05-15Journal article

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Urinary cotinine assessment of maternal smoking and environmental tobacco smoke exposure status and its associations with perinatal outcomes: a cross-sectional birth study

Publication . Silva, Ana Inês; Camelo, Alexandra; Madureira, Joana; Reis, Ana Teresa; Machado, Ana Paula; Teixeira, João Paulo; Costa, Carla

Abstract: 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.

2022-01Journal article

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The importance of smoking cessation during pregnancy and its association with perinatal outcomes

Publication . Silva, Ana Inês; Camelo, Alexandra; Madureira, Joana; Reis, Ana Teresa; Barbosa Jr, Fernando; Teixeira, João Paulo; Costa, Carla

In 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.

2021-11-10Conference object

Open access

The importance of socioeconomic position in smoking, cessation and environmental tobacco smoke exposure during pregnancy

Publication . Madureira, Joana; Camelo, Alexandra; Silva, Ana Inês; Reis, Ana Teresa; Esteves, Filipa; Ribeiro, Ana Isabel; Teixeira, João Paulo; Costa, Carla

Tobacco 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.

2020-09-24Journal article

Open access

Maternal tobacco smoke exposure and determination of the optimal urinary cotinine cut-off values: a cross-sectional birth study

Publication . Silva, AI; Camelo, Alexandra; Madureira, Joana; Reis, Ana Teresa; Barbosa, Fernando Jr; Teixeira, J,P,; Costa, Carla

Within 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.

2021Conference object

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