American Journal of Epidemiology Vol. 148, No. 3: 259-262
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Serum Cotinine Concentration and Self-reported Smoking during Pregnancy
1 Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health Bethesda, MD
2 Center for Human Toxicology, University of Utah Salt Lake City, UT
Reprint requests to Dr. Mark A. Klebanoff, Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, 6100 Building, Room 7B03, Bethesda, MD 20892-7510.
Although during pregnancy there is a better correlation between matermal 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. Am J Epidemiol 1998;148:259–62.
cotinine; pregnancy; smoking
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