title: The Collection and Analysis of Carbon Monoxide Levels as an Indirect Measure of Smoke Exposure in Pregnant Adolescents at a Multidisciplinary Teen Obstetrics Clinic.
abstract: OBJECTIVE
  In this study we aimed to collect and analyze CO levels as an indirect measure of smoke exposure in pregnant adolescents.
  
  
  METHODS
  Participants included pregnant adolescents who received antenatal care over 18 months (2012-2013) at the Multidisciplinary Teen Obstetrics Clinic at a tertiary-care hospital in Southeastern Ontario.
  
  
  METHODS
  The CO breath test is a noninvasive method that is used to assess smoke exposure, in which nonsmokers have levels of 0-6 ppm, and levels of 7-10, 11-20 and more than 20 ppm are consistent with light, typical, and heavy smokers, respectively. Expired CO, smoking status, cigarette number, and home secondhand smoke exposure were documented at 3 clinic visits.
  
  
  METHODS
  To determine mean CO levels as a measure of smoke exposure and prevalence of secondhand smoke exposure.
  
  
  RESULTS
  The mean age of participants was 17.6 years. CO means (ppm) across 3 visits were 6.0, 5.9, and 4.8. Sixty-two percent of patients were self-reported nonsmokers, 38% were self-reported smokers (n = 93). CO means (standard error of the mean) were consistently different for nonsmokers vs smokers at visits 1 to 3, respectively: 2.9 (0.79) vs 9.7 (1.8); 3.0 (0.71) vs 12.9 (2.2), and 2.4 (0.71) vs 8.8 (1.5; P < .01, t test; n = 91). Of patient's highest CO (COmax), 62%, 9%, 15%, and 12% had levels of 6 or less, 7-10, 11-20, and greater than 20, respectively. Eighty-four percent of pregnant adolescents had home secondhand smoke exposure, which included 40% of nonsmokers and 100% of smokers (n = 57). Although most nonsmokers had a COmax of 6 or fewer ppm, 56% of smokers had COmax greater than 10 ppm (P < .05, χ(2)).
  
  
  CONCLUSIONS
  Emphasis on smoking cessation is imperative in pregnant adolescents and should particularly target partners and families, because secondhand smoke exposure was very prevalent.
authors.affiliation: Queen's University, Kingston, Ontario, Canada.
authors.forename: Ana Sofia
authors.initials: AS
authors.lastname: Lopez
authors.affiliation: Queen's University, Kingston, Ontario, Canada; Kingston General Hospital, Kingston, Ontario, Canada.
authors.forename: Ashley
authors.initials: A
authors.lastname: Waddington
authors.affiliation: Queen's University, Kingston, Ontario, Canada; Kingston General Hospital, Kingston, Ontario, Canada.
authors.forename: Wilma M
authors.initials: WM
authors.lastname: Hopman
authors.affiliation: Queen's University, Kingston, Ontario, Canada; Kingston General Hospital, Kingston, Ontario, Canada. Electronic address: maj3@queensu.ca.
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Jamieson
mesh_terms: D000293:Adolescent; D001944:Breath Tests; D002248:Carbon Monoxide / Q000032:analysis*; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000032:analysis*; D008297:Male; D009774:Obstetrics; D009864:Ontario; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D011295:Prenatal Care / Q000379:methods; D057566:Self Report; D012907:Smoking / Q000378:metabolism*; D014028:Tobacco Smoke Pollution / Q000032:analysis*
chemical_list: D014028:Tobacco Smoke Pollution; D002248:Carbon Monoxide
keywords: Adolescent; Carbon monoxide (CO); Pregnancy; Pregnancy in Adolescence; Smoking; Smoking cessation