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Cited by 192Smoking Behavior and CessationPrenatal Substance Exposure EffectsStatistical Methods in Epidemiology

Self-reported nicotine exposure and plasma levels of cotinine in early and late pregnancy

GEORGE, LENA, GRANATH, FREDRIK, JOHANSSON, ANNA L.V., CNATTINGIUS, SVEN·2006·Acta Obstetricia Et Gynecologica Scandinavica
DOI 10.1080/00016340600935433
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Abstract

BACKGROUND: The accuracy of maternal self-reported smoking information, especially exposure to environmental tobacco smoke, has been questioned. This study aimed to validate self-reported smoking, smoking cessation, and environmental tobacco smoke exposure in early and late pregnancy, using the biomarker cotinine as the gold standard. METHODS: Prospective cohort study of 953 pregnant Swedish women between 1996 and 1998. In-person interviews and cotinine measurements were performed at 6-12 and 31-34 completed weeks of gestation. All women were asked about nicotine exposures throughout pregnancy, including cigarette smoking, oral snuff, nicotine replacement therapy, and environmental tobacco smoke exposure. RESULTS: The validity of self-reported daily smoking was high in early and late pregnancy. However, among women reporting smoking cessation before the first interview and between the first and second interviews, 13% and 25% misreported active smoking, respectively. According to cotinine measurements, 22% of non-smoking women were exposed to environmental tobacco smoke in early pregnancy, and 8% were exposed in late pregnancy. Self-reported information on environmental tobacco smoke exposure in early and late pregnancy misclassified most exposed women as unexposed. CONCLUSION: The results of this study indicate that self-reported smoking information among pregnant women can be trusted. However, among women reporting smoking cessation during pregnancy, the misclassification rate increased with recency of quitting. Environmental tobacco smoke exposure was common among non-smokers, and the low validity of self-reported environmental tobacco smoke exposure suggests that future studies on environmental tobacco smoke exposure and risks of pregnancy outcomes may have to rely on biomarker assessments.

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  • A Swedish study comparing self-reported nicotine exposure and plasma cotinine concluded that self-reported information on nicotine exposure had acceptable validity.

    “Nevertheless, a study performed in Sweden comparing self-reported nicotine exposure and plasma levels of cotinine in early and late pregnancy concluded that self-reported information on nicotine exposure had acceptable validity [49].”

    From The effect of swedish snuff (snus) on offspring birthweight: a sibling analysis (2013) · cites this paper as [49]

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Authors
GEORGE, L., GRANATH, F., JOHANSSON, A. L. V., & CNATTINGIUS, S.
Affiliations
  • Karolinska Institutet (SE)
  • Karolinska University Hospital (SE)
Corresponding author
GEORGE, LENA
ORCID
Venue
Acta Obstetricia Et Gynecologica Scandinavica
Publisher
Wiley
Published
2006-11
Volume
85
Issue
11
Pages
1331-1337
ISSN
  • 0001-6349 (ISSN-L)
  • 1600-0412
DOI
10.1080/00016340600935433
OpenAlex
W1968549649
Cited by
192
References
21
Citations by year
2026: 2 · 2025: 6 · 2024: 5 · 2023: 5 · 2022: 14 · 2021: 7 · 2020: 13 · 2019: 8 · 2018: 10 · 2017: 8 · 2016: 5 · 2015: 11 · 2014: 11 · 2013: 11 · 2012: 14
FWCI
7.73
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 1521 d)
Locations
  • Acta Obstetricia Et Gynecologica Scandinavica (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
Keywords
maternal smoking, self-reported smoking, cotinine, passive smoking, smoking cessation, misclassification, biomarker validation, oral snuff, nicotine replacement therapy, pregnancy, early pregnancy, late pregnancy
MeSH terms
Cotinine, Female, Humans, Nicotine, Pregnancy, Pregnancy Trimester, First, Pregnancy Trimester, Third, Prospective Studies, Self Disclosure, Smoking, Tobacco Smoke Pollution, Smoking Cessation, Maternal Exposure

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