Mid-Pregnancy Cotinine and Risks of Orofacial Clefts and Neural Tube Defects
Received 21 April 2008; received in revised form 30 June 2008; accepted 5 August 2008. published online 06 November 2008.
Refers to article:
Looking Ahead to a Tobacco-Free Generation
, 06 November 2008
Cynthia F. Bearer, Matthew A. Stefanak
The Journal of Pediatrics
January 2009 (Vol. 154, Issue 1, Pages 4-5) Full Text |
Full-Text PDF (70 KB)
Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days
, 06 November 2008
Laura R. Stroud, Rachel L. Paster, George D. Papandonatos, Raymond Niaura, Amy L. Salisbury, Cynthia Battle, Linda L. Lagasse, Barry Lester
The Journal of Pediatrics
January 2009 (Vol. 154, Issue 1, Pages 10-16) Abstract |
Full Text |
Full-Text PDF (128 KB)
Objective
Past studies of cigarette smoking as a contributor to orofacial clefts and neural tube defects (NTDs) used self-reports of smoke exposures. We have correlated measurements of cotinine (a nicotine metabolite) in mid-pregnancy sera with clefts and NTDs.
Study design
From a repository of >180 000 mid-pregnancy serum specimens collected in California from 2003 to 2005 and linked to delivery outcome information, we identified 89 orofacial cleft-associated pregnancies, 80 NTD-affected pregnancies, and randomly selected 409 pregnancy specimens that corresponded to infants without malformations as control subjects. Cotinine was measured by liquid chromatography-mass spectrometry. No smoke exposure was defined as cotinine values <2 ng/mL, and any exposure was defined as ≥2 ng/mL.
Results
We observed odds ratios of 2.1 (95% CI, 1.0-4.4) for clefts and 0.4 (95% CI, 0.1-1.7) for NTDs associated with exposure. After adjusting for race/ethnicity, age, and serum folate levels, odds ratios were 2.4 (95% CI, 1.1-5.3) and 0.6 (95% CI, 0.1-2.5). We explored 2 cotinine levels, 2 to 10 ng/mL and >10 ng/mL for clefts (data were too sparse for NTDs). Odds ratios for these levels were 3.3 (95% CI, 0.9-11.9) and 1.7 (95% CI, 0.7-4.2), respectively.
Conclusion
Smoking exposures, as measured with cotinine levels during mid-pregnancy, were associated with increased risks of clefts and possibly reduced risks of NTDs.
fSection for Pharmacology, Institute of Medicine, University of Bergen and Haukeland University Hospital, Armauer Hansens Huz, Bergen, Norway
Reprint requests: Dr Gary Shaw, March of Dimes California Research Division, Children's Hospital Oakland Research Institute, 5700 Martin Luther King Jr Way, Oakland, CA 94609
Supported by funds from the Centers for Disease Control and Prevention, Center of Excellence Award U50/CCU913241 and by NIH/NINDS R01 NS050249. The authors declare no potential conflicts of interest.
ABSTRACT