Klebanoff M A, Levine R J, Clemens J D, DerSimonian R, Wilkins D G
Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Instiutes of Health, Bethesda, MD 20892-7510, USA.
Am J Epidemiol. 1998 Aug 1;148(3):259-62. doi: 10.1093/oxfordjournals.aje.a009633.
Although during pregnancy there is a better correlation between maternal serum cotinine concentration and adverse outcome than between self-reported smoking and such an outcome, few studies of pregnancy have measured cotinine concentration to determine how much a woman smokes. This study assessed the accuracy of self-reported smoking during pregnancy by performing serum cotinine assays on 448 women registered in the Collaborative Perinatal Project (1959-1966). Based on the assumption that a serum cotinine concentration of >10 ng/ml represented active smoking, 94.9% of women who denied smoking and 87.0% of women who stated that they smoked (kappa=0.83) reported their status accurately. Among smokers, the correlation coefficient between cotinine concentration and number of cigarettes smoked per day was 0.44. Serum cotinine concentration correlated more strongly than self-reported smoking with infant birth weight (r=0.246 vs. 0.200). In conclusion, this study showed that pregnant women accurately reported whether they smoked, but cotinine concentration was a better measure than self-report of the actual tobacco dose received.
尽管孕期母亲血清可替宁浓度与不良结局之间的相关性比自我报告的吸烟情况与不良结局之间的相关性更好，但很少有关于孕期的研究测量可替宁浓度以确定女性的吸烟量。本研究通过对协作围产期项目（1959 - 1966年）登记的448名女性进行血清可替宁检测，评估了孕期自我报告吸烟情况的准确性。基于血清可替宁浓度>10 ng/ml代表当前吸烟的假设，94.9%否认吸烟的女性和87.0%声称吸烟的女性（kappa = 0.83）准确报告了她们的吸烟状况。在吸烟者中，可替宁浓度与每日吸烟支数之间的相关系数为0.44。血清可替宁浓度与婴儿出生体重的相关性比自我报告吸烟更强（r = 0.246对0.200）。总之，本研究表明孕妇能准确报告她们是否吸烟，但可替宁浓度比自我报告更能准确衡量实际摄入的烟草剂量。
