Comparison of prenatal self-report of tobacco use to direct measurement of umbilical cord cotinine.

OBJECTIVE

This study compared maternal self-reports of prenatal tobacco product use with biochemically confirmed cotinine in umbilical cord tissue in newborns exposed to opioids in utero and unexposed controls.

STUDY

DESIGN

Secondary data analysis on 179 pregnant women and newborns. Chi-square and t-tests were used to compare sociodemographic factors of those who did and did not self-report tobacco use.

RESULTS

Mean (SD) maternal age was 29.5 years (5.0); 85.2% had public insurance, and 92 (51.4%) took opioids prenatally. Ninety-five (53.1%) mothers self-reported prenatal tobacco product and/or e-cigarette use, with cord cotinine detected in 98.9%. Of the 84 reporting no use, cotinine detection was 34.5%, resulting in moderate agreement (Gwet's AC1 = 0.68 (0.571, 0.788), p < 0.001). Of those reporting no use, 27 (32.9%) had cotinine detected (p = 0.038).

CONCLUSIONS

Biochemically verified cotinine detection was much higher than maternal self-reports of prenatal tobacco use. Inquiring about household and community smoke exposure may help inform optimal care.