International Journal of Epidemiology, Vol 26, 978-988, Copyright © 1997 by International Epidemiological Association
X Wang, IB Tager, H Van Vunakis, FE Speizer and JP Hanrahan
BACKGROUND: Most studies of the reproductive consequences of cigarette
smoking base exposure on self-reported smoking habits. This study examines
the relationship of birth outcomes to the timing and intensity of maternal
active and passive smoking estimated both from self-reports and from
cotinine concentration in maternal urine during early, middle, and late
gestation. METHOD: This cohort study included 740 white and Hispanic women
who obtained antenatal care at the East Boston Neighborhood Health Center
between 1986 and 1992. At each antenatal visit, information on maternal
active and passive smoking was obtained by a detailed questionnaire, and by
measurement of urine cotinine concentrations. Infant birth outcomes were
obtained from hospital records. Multiple linear regression was used to
evaluate antenatal smoking variables on birth outcomes, with adjustment for
maternal demographic characteristics, reproductive history, alcohol use,
maternal weight and height, and infant gender. RESULTS: The percentage of
mothers who ever smoked cigarettes during pregnancy was 55.5% for white and
10.2% for Hispanic women. A significant inverse exposure- response
relationship between cotinine concentration in maternal urine and infant
size at birth was demonstrated. However, the relationship was less clear
between maternal self-reported smoking status and these outcomes. For the
entire gestation, a 1000 ng increase in mean urine cotinine concentration
was associated with a 59 +/- 9 g reduction in birthweight, a 0.25 +/- 0.05
cm reduction in length, and a 0.12 +/- 0.03 cm reduction in head
circumference, respectively. For maternal passive smoking, the much smaller
magnitude of effect precludes firm conclusions. CONCLUSIONS: These data
suggest that preventing and reducing active maternal smoking during
pregnancy may have a beneficial impact on infant size at birth.
ARTICLES
Maternal smoking during pregnancy, urine cotinine concentrations, and birth outcomes. A prospective cohort study
Department of Pediatrics, Boston University School of Medicine, MA, USA.
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