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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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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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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DOI: https://doi.org/10.1007/s10995-008-0350-4