Mattsson Kristina, Källén Karin, Rignell-Hydbom Anna, Lindh Christian H, Jönsson Bo A G, Gustafsson Peik, Olofsson Per, Ivarsson Sten A, Rylander Lars
Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, Lund, Sweden;
Department of Child and Adolescent Psychiatry, Institution of Clinical Sciences, Lund University, Lund, Sweden;
Nicotine Tob Res. 2016 Jan;18(1):79-83. doi: 10.1093/ntr/ntv087. Epub 2015 Apr 20.
Self-reported data on smoking during pregnancy from the Medical Birth Register of Sweden (MBR) are widely used. However, underreporting of such behavior may occur, leading to biases. It is of importance to validate the smoking data in the MBR. The main objective was to investigate the agreement between self-reported smoking data from the MBR and cotinine levels in maternal serum among women from the general population in the region of Skåne, Sweden. We also estimated the transfer of cotinine from mother to fetus.
From a cohort used previously to investigate the relationship between intrauterine environmental exposures and offspring neuropsychiatric outcomes, there were 204 control children retrieved from the MBR with data on maternal smoking in early pregnancy registered. Data on maternal and umbilical cord cotinine at delivery were available for these children from a regional biobank.
There was a high agreement between cotinine levels and MBR smoking data (κ = 0.82) and a high correlation between cotinine levels in maternal and umbilical cord serum (r s = 0.90, P < .001). Of the self-reported nonsmokers, 95% (95% confidence interval: 89% to 97%) were classified as nonsmokers after cotinine measurements.
In these data, we found that the agreement between mothers' self-reported smoking habits during pregnancy and their levels of serum cotinine was high, as was the transfer of cotinine from mother to fetus. This indicates that birth register data on pregnancy smoking in Sweden could be considered a valid measure.
瑞典医学出生登记册（MBR）中关于孕期吸烟的自我报告数据被广泛使用。然而，此类行为可能存在报告不足的情况，从而导致偏差。验证MBR中的吸烟数据非常重要。主要目的是调查瑞典斯科讷地区普通人群中，MBR中自我报告的吸烟数据与孕妇血清中可替宁水平之间的一致性。我们还估计了可替宁从母亲到胎儿的转移情况。
从先前用于研究子宫内环境暴露与后代神经精神结局之间关系的队列中，从MBR中检索出204名对照儿童，其早期妊娠时母亲吸烟的数据已登记。这些儿童在分娩时母亲和脐带血中可替宁的数据可从一个地区生物样本库获得。
可替宁水平与MBR吸烟数据之间具有高度一致性（κ = 0.82），母亲和脐带血血清中可替宁水平之间具有高度相关性（r s = 0.90，P <.001）。在自我报告的非吸烟者中，95%（95%置信区间：89%至97%）在可替宁测量后被归类为非吸烟者。
在这些数据中，我们发现母亲孕期自我报告的吸烟习惯与其血清可替宁水平之间的一致性很高，可替宁从母亲到胎儿的转移情况也是如此。这表明瑞典出生登记册中关于孕期吸烟的数据可被视为一种有效的测量方法。
