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Fetal Exposure to Secondhand Tobacco Smoke Assessed by Maternal Self-reports and Cord Blood Cotinine: Prospective Cohort Study in Krakow

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Abstract

Objectives While the validity of self-reported smoking habits is generally judged as satisfactory, objective markers of secondhand smoke (SHS) exposure may be more useful in validating the causal links between prenatal SHS and health effects. The cohort study in Krakow provided an opportunity for comparative assessment of fetal exposure to SHS based upon questionnaires and cord blood cotinine measurements. Methods The study sample included 467 newborns born to women recruited in the first and second trimester of pregnancy. To compare the validity of self-reported SHS and cord blood cotinine levels in assessing the association between fetal passive smoking and health effects of newborns, we separately examined the regression coefficients of birthweight on self-reported number of cigarettes smoked by other household members during the entire pregnancy and cord blood cotinine levels. Results In the non-exposed newborns the geometric mean of cord blood cotinine was 0.077 ng/ml and was significantly lower than in newborns with a maternal report of SHS. Cord cotinine levels were more highly correlated with a self-reported number of cigarettes smoked daily at home in the third trimester of pregnancy. The two measures of SHS (number of cigarettes and number of hours of daily exposure) were equally well correlated with cord blood cotinine levels. Using cotinine as the exposure variable, overall the association was not significant; but among the subgroup with cord cotinine levels above the median (≥0.083 ng/ml), the association with birthweight was significant (beta coefficient = −113.65, P = 0.041). Conclusion The study provides evidence that the assessment of fetal SHS exposure based on cord blood cotinine produced better estimates of the association between exposure and birth outcomes.

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References

  1. Lowe, C. R. (1959). Effect of mothers’ smoking habits on birth weight of children. British Medical Journal, 2, 673–675.

    PubMed  CAS  Google Scholar 

  2. Miller, H. C., Hasseinein, K., & Hensleigh, P. A. (1976). Fetal growth retardation in relation to maternal smoking and weight gain in pregnancy. American Journal of Obstetrics and Gynecology, 125, 53–60.

    Google Scholar 

  3. Nieburg, P., Marks, J. S., McLaren, N. M., & Remington, P. L. (1985). The fetal tobacco syndrome. JAMA, 253, 2998–2999.

    Article  PubMed  CAS  Google Scholar 

  4. Taylor, B., & Wadsworth, J. (1987). Maternal smoking during pregnancy and lower respiratory tract illness in early life. Archives of Disease in Child, 62, 766–791.

    Google Scholar 

  5. Martinez, F. D., Cline, M., & Burrows, B. (1992). Increased incidence of asthma in children of smoking mothers. Pediatrics, 89, 21–26.

    PubMed  CAS  Google Scholar 

  6. Tager, I. B., Hanrahan, J. P., Tosteson, T. D., Castile, R. G., Brown, R. W., Weiss, S. T., & Speizer, F. E. (1993). Lung function, pre- and post-natal smoke exposure, and wheezing in the first year of life. American Review of Respiratory Disease, 147, 811–817.

    PubMed  CAS  Google Scholar 

  7. DiFranza, J. R., Aligne, C. A., & Weitzman, M. (2004). Prenatal and postnatal environmental tobacco smoke exposure and children’s health. Pediatrics, 113, 1007–1015.

    PubMed  Google Scholar 

  8. Samet, J. M., Marbury, M. C., & Spengler, J. D. (1987). Health effects and sources of indoor air pollution. Part I. American Review of Respiratory Disease, 136, 1486–1508.

    PubMed  CAS  Google Scholar 

  9. Rando, R. J., Simlote, P., Salvaggio, J. E., & Lehrer, S. B. (1996). Environmental tobacco smoke: Measurement and health effects of involuntary smoking. In E. J. Bardana & A. Monatanaro (Eds.), Indoor air pollution and health (pp. 61–82). New York: Marcel Dekker Inc.

    Google Scholar 

  10. Martin, T. R., & Bracken, M. B. (1986). Association of low birth weight with passive smoke exposure in pregnancy. American Journal of Epidemiology, 124(4), 633–642.

    PubMed  CAS  Google Scholar 

  11. Jedrychowski, W., & Flak, E. (1996). Confronting the prenatal effects of active and passive tobacco smoking on the birth weight of children. Central European Journal of Public Health, 4(3), 201–205.

    PubMed  CAS  Google Scholar 

  12. Windham, G. C., Eaton, A., & Hopkins, B. (1999). Evidence for an association between environmental tobacco smoke exposure and birthweight: A metaanalysis and new data. Pediatric and Perinatal Epidemiology, 13(1), 35–57.

    Article  PubMed  CAS  Google Scholar 

  13. Goel, P., Radotra, A., Singh, I., Aggarwal, A., & Dua, D. (2004). Effects of passive smoking on outcome in pregnancy. Journal of Postgraduate Medicine, 50, 12–16.

    PubMed  CAS  Google Scholar 

  14. Perera, F. P., Rauh, V., Whyatt, R. M., Tsai, W. Y., Bernert, J. T., Tu, Y. H., Andrews, H., Ramirez, J., Qu, L., & Tang, D. (2004). Molecular evidence of an interaction between prenatal environmental exposures and birth outcomes in a multiethnic population. Environmental Health Perspectives, 112(5), 626–630.

    PubMed  CAS  Google Scholar 

  15. The Health Consequence of Involuntary Exposure to Tobacco Smoke: A report of the Surgeon General. Chapter 5. Reproductive Developmental Effects from Exposure to Secondhand Smoke; 2006.

  16. Colley, J. T. R., Holland, W. W., & Corkhill, R. T. (1974). Influence of passive smoking and parental phlegm on pneumonia and bronchitis in early childhood. Lancet, 2, 1031–1034.

    Article  PubMed  CAS  Google Scholar 

  17. Pedreira, F. A., Guandolo, V. L., Feroli, E. J., Mella, G. W., & Weiss, I. P. (1985). Involuntary smoking and incidence of respiratory illness during the first year of life. Pediatrics, 75, 594–597.

    PubMed  CAS  Google Scholar 

  18. National Research Council. (1986). Environmental tobacco smoke: Measuring exposures and assessing health effects. Washington, DC: National Academy Press.

    Google Scholar 

  19. Etzel, R. A., Pattishall, E. N., Haley, N. J., Fletcher, R. H., & Henderson, F. W. (1992). Passive smoking and middle ear effusion among children in day care. Pediatrics, 90, 228–232.

    PubMed  CAS  Google Scholar 

  20. Cook, D. G., & Strachan, D. P. (1999). Summary of effects of parental smoking on the respiratory health of children and implications for research. Thorax, 54, 357–366.

    Article  PubMed  CAS  Google Scholar 

  21. Rebagliato, M., Florey, C. D. V., & Bolumar, F. (1995). Exposure to environmental tobacco-smoke in nonsmoking pregnant-women in relation to birth-weight. American Journal of Epidemiology, 142, 531–537.

    PubMed  CAS  Google Scholar 

  22. Jedrychowski, W., Galas, A., Flak, E., Jacek, R., Penar, A., Spengler, J., & Perera, F. P. (2007). Increased burden of respiratory disease in the first six months of life due to prenatal environmental tobacco smoke: Krakow birth cohort study. Early Child Development and Care, 177, 369–381.

    Article  Google Scholar 

  23. Tanis, B. C., Kapiteijn, K., Hage, R. M., Rosendaal, F. R., & Helmerhorst, F. M. (2005). Dutch women with low birth weight have an increased risk of myocardial infarction later in life: A case control study. Reproductive Health, 2(1), 1–4.

    Article  PubMed  Google Scholar 

  24. Idle, J. R. (1990). Titrating exposure to tobacco smoke using cotinine; A minefield of misunderstandings. Journal of Clinical Epidemiology, 43, 313–317.

    Article  PubMed  CAS  Google Scholar 

  25. Delfino, R. J., Ernst, P., Jaakkola, M. S., et al. (1993). Questionnaire assessments of recent exposure to environmental tobacco smoke in relation to salivary cotinine. European Respiratory Journal, 6, 1104–1108.

    PubMed  CAS  Google Scholar 

  26. Peterson, E. L., Johnson, C. C., & Ownby, D. R. (1997). Use of urinary cotinine and questionnaires in the evaluation of infant exposure to tobacco smoke in epidemiologic studies. Journal of Clinical Epidemiology, 50, 917–923.

    Article  PubMed  CAS  Google Scholar 

  27. Kemmeren, J. M., van Poppel, G., Verhoef, P., et al. (1994). Plasma cotinine: Stability in smokers and validation of self-reported smoke exposure in nonsmokers. Environmental Research, 66, 235–243.

    Article  PubMed  CAS  Google Scholar 

  28. England, L. J., Kendrick, J. S., Gargiullo, P. M., Zahniser, S. C., & Hannon, W. H. (2001). Measures of maternal tobacco exposure and infant birth weight at term. American Journal of Epidemiology, 153, 954–960.

    Google Scholar 

  29. Bernert, J. T. (2002). Estimation of environmental tobacco smoke exposure during pregnancy using a single question on household smokers versus serum cotinine. Journal of Exposure Analysis and Environmental Epidemiology, 12, 1–10.

    Article  Google Scholar 

  30. Jedrychowski, W., Whyatt, R., Camann, D., Bawle, U., Peiki, K., Spengler, J., Dumyahn, T., & Perera, F. (2003). Effect of prenatal PAH exposure on birth outcomes and neurocognitive development among a cohort of Polish mothers and newborns. Study design and preliminary ambient data. International Journal of Occupational Medicine and Environmental Health, 16, 21–29.

    PubMed  Google Scholar 

  31. Bernert, J. T., Turner, W. E., Pirkle, J. L., Sosnoff, C. S., Akins, J. R., & Waldrep, M. K. (1997). Development and validation of sensitive method for determination of serum cotinine in smokers and nonsmokers by liquid chromatography/atmospheric pressure ionization tandem mass-spectrometry. Clinical Chemistry, 43, 2281–2291.

    PubMed  CAS  Google Scholar 

  32. Bernert, J. T., McGuffey, J. E., Morrison, M. A., & Pirkle, J. L. (2000). Comparison of serum and salivary cotinine measurements by a sensitive high-performance liquid chromatography-tandem mass spectrometry method as an indicator of exposure to tobacco smoke among smokers and nonsmokers. Journal of Analytical Toxicology, 24, 333–339.

    PubMed  CAS  Google Scholar 

  33. Jarvis, M. J., Tunstall-Pedoe, H., Feyerabend, C., Vesey, C., & Saloojee, Y. (1987). Comparison of tests used to distinguish smokers from nonsmokers. American Journal of Public Health, 77, 435–438.

    Article  Google Scholar 

  34. Peacock, J., Cook, D. G., Carey, J. M., Jarvis, M. J., Bryant, A. E., & Anderson, H. R. (1998). Maternal cotinine level during pregnancy and birthweight for gestational age. International Journal of Epidemiology, 27, 647–656.

    Article  PubMed  CAS  Google Scholar 

  35. Haddow, J. E., Knight, G. J., Palomaki, G. E., & McCarthy, J. E. (1988). Second-trimester serum cotinine levels in nonsmokers in relation to birth weight. American Journal of Obstetrics and Gynecology, 159, 481–484.

    PubMed  CAS  Google Scholar 

  36. DeLorenze, G. N., Kharrazi, M., Kaufman, F. L., Eskenazi, B., & Bernert, J. T. (2002). Exposure to environmental tobacco smoke in pregnant women: The association between self-report and serum cotinine. Environmental Research Section, 90, 21–32.

    Article  CAS  Google Scholar 

  37. Picchini, S., Basagna, X., Pacifici, R., Garcia, O., Puig, C., Vall, O., Harris, J., Zuccaro, P., Segura, J., & Sunyer, J. (2000). Cord serum cotinine as a biomarker of fetal exposure to cigarette smoke at the end of pregnancy. Environmental Health Perspectives, 108, 1079–1083.

    Article  Google Scholar 

  38. Kaufman, F. L., Kharrazi, M., DeLorenzo, G. N., Eskenazi, B., & Bernert, J. T. (2002). Estimation of environmental tobacco smoke exposure during pregnancy using a single question on household smokers versus serum cotinine. Journal of Exposure Analysis and Environmental Epidemiology, 12, 286–295.

    Article  PubMed  CAS  Google Scholar 

  39. O’Connor, T. Z., Holfor, T. R., & Leaderer, B. P. (1995). Measurement of exposure to environmental tobacco smoke in pregnant women. American Journal of Epidemiology, 142, 1315–1321.

    PubMed  CAS  Google Scholar 

  40. Benowitz, N. L. (1996). Cotinine as a biomarker of environmental tobacco smoke exposure. Epidemiologic Reviews, 18, 188–204.

    PubMed  CAS  Google Scholar 

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Acknowledgments

This is part of an ongoing comparative longitudinal investigation on the health impact of prenatal exposure to outdoor/indoor air pollution in infants and children being conducted in New York City and Krakow. The study received funding from an RO1 grant entitled, “Vulnerability of the Fetus/Infant to PAH, PM2.5 and ETS” (5 RO1 ES10165 NIEHS; 02/01/00–01/31/04) and from the NIEHS (RO1 ES010165-0451) the Lundin Foundation and the Gladys T. and Roland Harriman Foundation. Principal investigator: Prof. FP Perera.

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Correspondence to Wieslaw Jedrychowski.

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The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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Jedrychowski, W., Perera, F., Mroz, E. et al. Fetal Exposure to Secondhand Tobacco Smoke Assessed by Maternal Self-reports and Cord Blood Cotinine: Prospective Cohort Study in Krakow. Matern Child Health J 13, 415–423 (2009). https://doi.org/10.1007/s10995-008-0350-4

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