Eliopoulos C, Klein J, Chitayat D, Greenwald M, Koren G
Division of Clinical Pharmacology/Toxicology, Hospital for Sick Children, Toronto, Ont.
Clin Invest Med. 1996 Aug;19(4):231-42.
To determine the extent of fetal exposure to cigarette smoke, which cannot be clearly extrapolated from maternal reports, the authors measured concentrations of nicotine and cotinine in maternal and neonatal hair and corroborated these measures with maternal history and measures of pregnancy outcome.
Prospective study of 94 mother-infant pairs.
Newborn nurseries of two hospitals in Toronto.
93 mothers, including active smokers, passive smokers and nonsmokers, and their newborns (including one set of twins).
Hair collected from mothers and neonates shortly after birth was analysed by radio-immunoassay.
Maternal data on demographic variables, obstetric history, diseases, drugs taken and smoking; infant data on demographic variables and birth indicators (gestational age, method of delivery, weight, head circumference, length, presence of meconium, need for resuscitation, need for special care and congenital malformations); hair concentrations of nicotine and cotinine.
Neonates of active smokers had more adverse outcomes than other infants, including lower birth weight, smaller head circumference, shorter length and more perinatal complications. The difference was statistically significant. Amounts of cotinine extracted from mothers' and infants' hair showed significant differences among active smokers, passive smokers and non-smokers. When other people in the household and the mother smoked, neonatal hair concentrations of nicotine and cotinine in the infants were threefold higher than those in the infants of mothers who were the only smokers in their households.
Hair concentrations of nicotine and cotinine are a powerful biological marker of the extent of intrauterine exposure to tobacco smoke.
为确定胎儿暴露于香烟烟雾中的程度（这无法从母亲的报告中明确推断出来），作者测量了母亲和新生儿头发中尼古丁和可替宁的浓度，并通过母亲的病史及妊娠结局指标对这些测量结果进行了验证。
对94对母婴进行的前瞻性研究。
多伦多两家医院的新生儿病房。
93名母亲，包括主动吸烟者、被动吸烟者和不吸烟者，以及她们的新生儿（包括一对双胞胎）。
出生后不久采集的母亲和新生儿的头发通过放射免疫分析法进行分析。
母亲的人口统计学变量、产科病史、疾病、用药及吸烟情况的数据；婴儿的人口统计学变量和出生指标（胎龄、分娩方式、体重、头围、身长、胎粪情况、复苏需求、特殊护理需求及先天性畸形）；头发中尼古丁和可替宁的浓度。
主动吸烟者的新生儿比其他婴儿出现更多不良结局，包括出生体重较低、头围较小、身长较短及更多围产期并发症。差异具有统计学意义。从母亲和婴儿头发中提取的可替宁量在主动吸烟者、被动吸烟者和不吸烟者之间存在显著差异。当家庭中的其他人和母亲都吸烟时，婴儿头发中尼古丁和可替宁的浓度比家庭中唯一吸烟者母亲的婴儿高三倍。
头发中尼古丁和可替宁的浓度是子宫内暴露于烟草烟雾程度的有力生物学标志物。
