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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

2022-01Journal article Restricted access
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dc.contributor.authorSilva, Ana Inês
dc.contributor.authorCamelo, Alexandra
dc.contributor.authorMadureira, Joana
dc.contributor.authorReis, Ana Teresa
dc.contributor.authorMachado, Ana Paula
dc.contributor.authorTeixeira, João Paulo
dc.contributor.authorCosta, Carla
dc.date.accessioned2023-01-16T15:04:47Z
dc.date.available2023-01-16T15:04:47Z
dc.date.issued2022-01
dc.description.abstractAbstract: 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.pt_PT
dc.description.abstractHighlights: UC cut-off value to distinguish pregnant non-smokers from smokers was 74.1 ng/mL; UC cut-off value to differentiate non-exposed from exposed to ETS was 1.6 ng/mL; Self-reported and UC-based smoking status showed a very good agreement;; Maternal smoking decreased newborn's birth weight, length and head circumference; Maternal smoking cessation eliminated the smoking-associated deficits in birth weight.pt_PT
dc.description.sponsorshipThis work was supported by FCT and FAPESP (FAPESP/19914/ 2014). The authors are grateful to the Foundation for Science and Technology (FCT, Portugal) for financial support by national funds FCT/ MCTES to EPIUnit (UID/DTP/04750/2019). Ana Inês Silva, Carla Costa and Joana Madureira also acknowledge FCT for individual funding (SFRH/BD/145101/2019, SFRH/BPD/96196/2013 and SFRH/BPD/ 115112/2016 grants, respectively)pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEnviron Res. 2022 Jan;203:111827. doi: 10.1016/j.envres.2021.111827. Epub 2021 Aug 5.pt_PT
dc.identifier.doi10.1016/j.envres.2021.111827pt_PT
dc.identifier.issn0013-9351
dc.identifier.urihttp://hdl.handle.net/10400.18/8439
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier/ Academic Presspt_PT
dc.relationEpidemiology Research Unit - Institute of Public Health, University of Porto
dc.relationEffects of in utero exposure to environmental contaminants: an epigenetic approach
dc.relationImpact of transplacental exposure to tobacco smoke in the DNA of newborn. Evaluation of genetic damage and epigenetic changes. Evolution throughout childhood.
dc.relationEarly life exposure to atmospheric air pollutants and potential DNA damage: Consequences on development and childhood outcomes APPEAL
dc.relation.publisherversionhttps://linkinghub.elsevier.com/retrieve/pii/S0013-9351(21)01121-Xpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectEnvironmental Tobacco Smoke Exposurept_PT
dc.subjectSmokingpt_PT
dc.subjectUrinary Cotininept_PT
dc.subjectPregnancypt_PT
dc.subjectPerinatal Outcomespt_PT
dc.subjectMaternal Exposurept_PT
dc.subjectAvaliação do Riscopt_PT
dc.titleUrinary cotinine assessment of maternal smoking and environmental tobacco smoke exposure status and its associations with perinatal outcomes: a cross-sectional birth studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleEpidemiology Research Unit - Institute of Public Health, University of Porto
oaire.awardTitleEffects of in utero exposure to environmental contaminants: an epigenetic approach
oaire.awardTitleImpact of transplacental exposure to tobacco smoke in the DNA of newborn. Evaluation of genetic damage and epigenetic changes. Evolution throughout childhood.
oaire.awardTitleEarly life exposure to atmospheric air pollutants and potential DNA damage: Consequences on development and childhood outcomes APPEAL
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UID%2FDTP%2F04750%2F2019/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/POR_NORTE/SFRH%2FBD%2F145101%2F2019/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT//SFRH%2FBPD%2F96196%2F2013/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT//SFRH%2FBPD%2F115112%2F2016/PT
oaire.citation.startPage111827pt_PT
oaire.citation.titleEnvironmental Researchpt_PT
oaire.citation.volume203pt_PT
oaire.fundingStream6817 - DCRRNI ID
oaire.fundingStreamPOR_NORTE
project.funder.identifierhttp://doi.org/10.13039/501100001871
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project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.embargofctAcesso de acordo com política editorial da revista.pt_PT
rcaap.rightsembargoedAccesspt_PT
rcaap.typearticlept_PT
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