Maternal smoking during pregnancy and nicotine and cotinine concentrations in maternal and neonatal hair
Maternal smoking during pregnancy and nicotine and cotinine concentrations in maternal and neonatal hair
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DOI：
10.1111/j.1471-0528.2002.01322.x
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发表时间：
2002-08-01
影响因子：
5.8
通讯作者：
Oury, JF
中科院分区：
文献类型：
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作者：
Jacqz-Aigrain, E;Zhang, D;Oury, JF
目的在母亲吸烟与孕期和新生儿不良反应之间的关系方面，已有相互矛盾的数据报道。一些研究在有限数量的患者身上进行，通过测量头发中的尼古丁和可替宁来评估母亲的摄入量和胎儿的暴露情况。我们的目的是在吸烟的孕妇群体中评估母亲吸烟、胎儿吸烟暴露和妊娠结局之间的关系。设计母亲在第一次产前探视时就包括在内，并进行前瞻性跟踪。收集了母亲数据(人口统计变量、产科病史和吸烟情况)、新生儿数据和出生指标(孕周数、分娩类型、体重)。母亲和婴儿出生时采集头发样本。本研究在巴黎罗伯特·德布雷大学医院产科进行。研究对象包括254名女性吸烟者，在排除50名头发样本不足的婴儿和22名其他原因的婴儿后，182对母亲/新生儿进行了分析。方法采用放射免疫法测定母亲和新生儿出生时头发中尼古丁和可替宁的浓度。主要观察指标是基于自我报告的吸烟情况，并量化每三个月的吸烟情况。在怀孕的最后三个月，它被更准确地表达为每天每支烟的平均数量。结果孕妇头发中尼古丁和可替宁浓度与妊娠晚期吸烟有关(P<；0.003)。在新生儿中，只有可替宁浓度与母亲吸烟有关(P<；0.0001)。在包括母亲毛可替宁浓度和种族的多变量分析中，这种相关性仍然显著。结论我们的结果表明，通过新生儿头发中可替宁浓度衡量，母亲吸烟和胎儿吸烟暴露之间存在很强的相关性。需要进一步的研究来寻找胎儿暴露与不良妊娠结局之间的联系。
Objective Conflicting data have been reported in the association between maternal smoking and adverse effects during pregnancy and in neonates. Some studies, conducted on a limited number of patients have evaluated maternal consumption and fetal exposure by measuring nicotine and cotinine in the hair. Our aims were to evaluate the relationship among maternal cigarette consumption, fetal smoking exposure and outcome of pregnancy in a population of pregnant women who smoked.Design Mothers smoking during pregnancy were included at their first prenatal visit and followed prospectively. Maternal data (demographic variables, obstetrical history and cigarette consumption), neonatal data and birth indicators (number of weeks of gestation, type of delivery, weight) were collected. Hair samples from the mothers and the babies were collected at birth.Setting The present study was conducted in the Department of Obstetrics of the University Hospital Robert Debre in Paris.Population A total of 254 women smokers were included in the study and 182 mother/neonate pairs were analyzed after exclusion of 50 babies whose hair samples were inadequate and 22 for various other reasons.Methods Nicotine and cotinine concentrations in the maternal and neonatal hair were measured at birth by radio-immunoassay.Main outcome measures Cigarette consumption was based on self reporting and quantified each trimester. It was expressed more precisely during the third trimester by the mean number per cigarette per day. Nicotine and cotinine concentrations in the maternal and neonatal hair at birth were also analysed.Results Nicotine and cotinine concentrations in maternal hair were associated with cigarette consumption during the third trimester of pregnancy (P < 0.003 and P < 0.01, respectively). In neonates, only cotinine concentrations were associated to maternal cigarette consumption (P < 0.0001). This association remained significant in a multivariate analysis, which included maternal cotinine hair concentrations and the ethnic group.Conclusions Our results have shown a strong relationship between maternal cigarette consumption and fetal exposure to smoking measured by cotinine concentrations in neonatal hair. Further studies are required to look for associations between fetal exposure and adverse pregnancy outcome.