title: High cotinine levels are persistent during the first days of life in newborn second hand smokers.
abstract: BACKGROUND
  Despite the adverse effects of maternal smoking during pregnancy on the newborn's health are well-known, in the pediatric population, a high prevalence exists that is very much affected by second hand smoke (SHS). This study aims to investigate the impact of maternal smoking habits during pregnancy on cotinine levels in newborns during the first days of life. The high association between cotinine concentration in maternal and umbilical cord blood (UCB) has been previously reported, but the levels of blood cotinine that remain in infants born to smokers is unknown.
  
  
  METHODS
  Cotinine concentration was measured in UCB, in maternal and newborn peripheral blood. Data from UCB sample dyads of ninety mothers and from seventy-one newborns were analyzed.
  
  
  RESULTS
  Cotinine levels were significantly different among non-smokers (9.9 ± 5.9 ng/ml), moderate (67.3 ± 7.4 ng/ml), and heavy smokers (137.7 ± 19.5 ng/ml) (p<0.0001). Significant correlations were found between maternal and UCB cotinine (r=0.748; p<0.001), and between UCB and newborn plasma cotinine at 48 h after birth (r=0.541; p<0.001). The smokers exposed their infants to cotinine with a median of 31.7 ± 8.6 ng/ml (moderate) or 59.1 ± 13.3 ng/ml (heavy smokers) until at least, 48 h after birth. Reduced birth weight and length were significantly related with UCB cotinine levels.
  
  
  CONCLUSIONS
  A positive association between UCB and plasmatic cotinine in newborns was found. The high cotinine levels detected in newborns from smoker mothers indicates that their infants are subjected to elevated SHS from birth. These results can help to reinforce the awareness of the adverse effects of smoking during pregnancy.
authors.affiliation: Cardiovascular Risk Unit, Hospital General, University of Valencia, Department of Pediatrics, Avenida Tres Cruces 2, Valencia, 46014, Spain; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, 28049, Spain. Electronic address: carmen.ivorra@uv.es.
authors.forename: Carmen
authors.initials: C
authors.lastname: Ivorra
authors.affiliation: Cardiovascular Risk Unit, Hospital General, University of Valencia, Department of Pediatrics, Avenida Tres Cruces 2, Valencia, 46014, Spain; CIBERER, Instituto de Salud Carlos III, Madrid, 28049, Spain. Electronic address: jec_jec_@hotmail.com.
authors.forename: Consuelo
authors.initials: C
authors.lastname: García-Vicent
authors.affiliation: Cardiovascular Risk Unit, Hospital General, University of Valencia, Department of Pediatrics, Avenida Tres Cruces 2, Valencia, 46014, Spain; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, 28049, Spain. Electronic address: siscopz80@hotmail.com.
authors.forename: Francisco
authors.initials: F
authors.lastname: Ponce
authors.affiliation: Cardiovascular Risk Unit, Hospital General, University of Valencia, Department of Pediatrics, Avenida Tres Cruces 2, Valencia, 46014, Spain. Electronic address: graore2@gmail.com.
authors.forename: Graciela
authors.initials: G
authors.lastname: Ortega-Evangelio
authors.affiliation: CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, 28049, Spain. Electronic address: joseaff@yahoo.es.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Fernández-Formoso
authors.affiliation: Cardiovascular Risk Unit, Hospital General, University of Valencia, Department of Pediatrics, Avenida Tres Cruces 2, Valencia, 46014, Spain; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, 28049, Spain. Electronic address: empar.lurbe@uv.es.
authors.forename: Empar
authors.initials: E
authors.lastname: Lurbe
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003367:Cotinine / Q000097:blood*; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange / Q000502:physiology*; D011247:Pregnancy; D012907:Smoking / Q000009:adverse effects / Q000097:blood*; D013997:Time Factors; D014028:Tobacco Smoke Pollution / Q000032:analysis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014028:Tobacco Smoke Pollution; D003367:Cotinine
keywords: Birth weight; Maternal smoking; Second hand smoke; Umbilical cord blood cotinine