Abstract

Smoking during pregnancy can have serious obstetric and fetal complications. Therefore, it is essential to identify in utero exposure to tobacco, being meconium the matrix of choice for this purpose. Meconium (n = 565) was analyzed for nicotine, cotinine and hydroxycotinine by LC–MS-MS. Then, tobacco meconium results were compared with smoking habits during pregnancy and neonatal outcomes measures (birth weight, length, head circumference, gestational age and Apgar scores). Although meconium analysis increased identification of in-utero exposure to tobacco (17.7% meconium positive specimens vs 13.5% mothers admitting tobacco use during pregnancy), there was a statistically significant relationship between meconium results and interview answers (P < 0.001). Birth weight was significantly lower for newborns with meconium positive results in males (P = 0.023) and females (P = 0.001), while for length significance was only observed in females (P = 0.001); however, when excluding meconium specimens positive for other drugs, a statistically significant difference was only found for female weight (P = 0.045). Meconium analysis proved to be more reliable for tobacco prenatal exposure detection than maternal interview. In addition, positive meconium results increased the probability for low birth weight, especially in females.

中文翻译：

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通过胎粪分析和母亲访谈评估怀孕期间的烟草暴露

摘要

怀孕期间吸烟会导致严重的产科和胎儿并发症。因此，至关重要的是确定子宫内暴露于烟草中，这是为此目的选择的胎粪。 通过LC-MS-MS分析了胎粪（n = 565）中的尼古丁，可替宁和羟基可卡因。然后，将烟草胎粪的结果与怀孕期间的吸烟习惯和新生儿结局指标（出生体重，身长，头围，胎龄和Apgar评分）进行比较。尽管胎粪分析增加了对子宫内暴露于烟草的识别（17.7％胎粪阳性样本与13.5％准许在怀孕期间使用烟草的母亲），但胎粪结果与访谈答案之间存在统计学上的显着相关性（P <0.001）。胎粪重量显着降低，在男性（P  = 0.023）和女性（P  = 0.001）中胎粪阳性的新生儿中，仅在女性中观察到胎龄显着（P  = 0.001）；但是，当排除对其他药物呈阳性的胎粪标本时，仅女性体重具有统计学上的显着差异（P  = 0.045）。事实证明，胎粪分析比产妇访谈对烟草产前暴露检测更可靠。此外，胎粪阳性的结果增加了低出生体重的可能性，特别是在女性中。