The Relationship between Maternal Smoking and Infant Birth Weight: Improving Accuracy through Urine Cotinine Analysis and Effective Medical Record Strategies

Vojisavljevic, Danica, Rudd, Donna, Smith, Roger, and Kandasamy, Yogavijayan (2024) The Relationship between Maternal Smoking and Infant Birth Weight: Improving Accuracy through Urine Cotinine Analysis and Effective Medical Record Strategies. Children, 11 (8). 1028.

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Abstract

Objective: We conducted a study to determine if antenatally collected maternal urine cotinine (a metabolite of nicotine) measurements can be used to assess the neonatal impact of nicotine exposure during pregnancy. This was a prospective longitudinal cohort of mother–infant dyads. Only term singleton pregnancies were included. The primary outcome measure was the correlation between maternal urine cotinine and infant birth weight.

Methods: We analysed data from 238 mother–neonate dyads. Smoking habits were recorded during routine prenatal check-ups and urine samples were collected to measure cotinine and creatinine levels.

Results: Urine cotinine was detected in 50.4% (120/238) of women from the whole cohort, but only 16% (38/238) self reported as smokers (chi-square 39.7, p < 0.0001), and these women had significantly smaller babies (p = 0.010). There was a significant negative correlation between maternal urine cotinine and birth weight (Spearman’s coefficient = −0.0226, p = 0.013). Female babies born to women with nicotine in their urine were significantly smaller (p = 0.001).

Conclusions: Infant birth weight significantly reduced in mothers with exposure to nicotine during pregnancy. The number of women exposed to nicotine during late pregnancy (measured in urine) was markedly higher than self-reported and national smoking percentages, suggesting an urgent need for an improvement in medical record reporting on smoking habits to better assess neonatal outcomes.

Item ID: 83614
Item Type: Article (Research - C1)
ISSN: 2227-9067
Keywords: cotinine, birth weight, sex, pregnancy, nicotine
Copyright Information: Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Funders: National Health and Medical Research Council of Australia (NHMRC)
Projects and Grants: NHMRC APP1159616
Date Deposited: 17 Sep 2024 00:21
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3213 Paediatrics > 321303 Neonatology @ 50%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320202 Clinical chemistry (incl. diagnostics) @ 25%
42 HEALTH SCIENCES > 4206 Public health > 420605 Preventative health care @ 25%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200104 Prevention of human diseases and conditions @ 100%
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