Vojisavljevic Danica, Rudd Donna, Smith Roger, Kandasamy Yogavijayan
College of Public Health, Medical and Veterinary Science, James Cook University, 1 James Cook Drive, Townsville, QLD 4814, Australia.
School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia.
Children (Basel). 2024 Aug 22;11(8):1028. doi: 10.3390/children11081028.
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.
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.
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, < 0.0001), and these women had significantly smaller babies ( = 0.010). There was a significant negative correlation between maternal urine cotinine and birth weight (Spearman's coefficient = -0.0226, = 0.013). Female babies born to women with nicotine in their urine were significantly smaller ( = 0.001).
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.
我们开展了一项研究，以确定产前采集的孕妇尿可替宁（尼古丁的一种代谢物）测量值是否可用于评估孕期尼古丁暴露对新生儿的影响。这是一项母婴二元组的前瞻性纵向队列研究。仅纳入足月单胎妊娠。主要结局指标是孕妇尿可替宁与婴儿出生体重之间的相关性。
我们分析了238对母婴二元组的数据。在常规产前检查期间记录吸烟习惯，并采集尿液样本以测量可替宁和肌酐水平。
在整个队列中，50.4%（120/238）的女性检测出尿可替宁，但只有16%（38/238）的女性自我报告为吸烟者（卡方检验值为39.7，<0.0001），这些女性所生婴儿明显较小（P = 0.010）。孕妇尿可替宁与出生体重之间存在显著负相关（斯皮尔曼系数=-0.0226，P = 0.013）。尿中含有尼古丁的女性所生的女婴明显较小（P = 0.001）。
孕期暴露于尼古丁的母亲所生婴儿的出生体重显著降低。晚期妊娠期间暴露于尼古丁的女性数量（通过尿液测量）明显高于自我报告的吸烟率和全国吸烟率，这表明迫切需要改进关于吸烟习惯的病历报告，以更好地评估新生儿结局。
