Serum cotinine concentration and self-reported smoking during pregnancy.
Although during pregnancy there is a better correlation between maternal serum cotinine concentration and adverse outcome than between self-reported smoking and such an outcome, few studies of pregnancy have measured cotinine concentration to determine how much a woman smokes. This study assessed the accuracy of self-reported smoking during pregnancy by performing serum cotinine assays on 448 women registered in the Collaborative Perinatal Project (1959-1966). Based on the assumption that a serum cotinine concentration of >10 ng/ml represented active smoking, 94.9% of women who denied smoking and 87.0% of women who stated that they smoked (kappa=0.83) reported their status accurately. Among smokers, the correlation coefficient between cotinine concentration and number of cigarettes smoked per day was 0.44. Serum cotinine concentration correlated more strongly than self-reported smoking with infant birth weight (r=0.246 vs. 0.200). In conclusion, this study showed that pregnant women accurately reported whether they smoked, but cotinine concentration was a better measure than self-report of the actual tobacco dose received.
Klebanoff
M A
MA
Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Instiutes of Health, Bethesda, MD 20892-7510, USA.
Levine
R J
RJ
Clemens
J D
JD
DerSimonian
R
R
Wilkins
D G
DG
D000328:Adult; D003367:Cotinine / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007124:Immunoenzyme Techniques; D015994:Incidence; D007231:Infant, Newborn; D018811:Maternal Exposure; D011247:Pregnancy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012650:Self Disclosure; D012907:Smoking / Q000097:blood / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
D003367:Cotinine