Assessment of prenatal smoke exposure by determining nicotine and its metabolites in maternal and neonatal urine

Abstract

Urine specimens were collected from 75 pregnant women before childbirth and from their newborns within 48 postnatal hours. A high-performance liquid chromatography (HPLC) method was used to determine urinary nicotine and its metabolites, cotinine and trans-3'-hydroxycotinine (OH-cotinine) to objectivise prenatal smoke exposure. Using the sum ofnicotine metabolites as a marker, 34 women were classed as not exposed to smoke (< 15 nmol/l), 18 as passive smokers (15-400 nmol/l), and 23 as active smokers (> 400 nmol/l). The newborns of active smokers exhibited significantly (P < 0.001) higher nicotine metabolite concentrations than did those of either non-exposed women or passive smokers. A close correlation was found to exist between maternal and neonatal nicotine and cotinine concentrations (r = 0.8968 and r = 0.9205, respectively). For OH-cotinine, this correlation was particularly close when maternal, but not neonatal, OH-cotinine was adjusted to creatinine (r = 0.9792). The neonatal/maternal urine concentration ratios for cotinine and OH-cotinine were noted to not significantly depend on the time of postpartal urine collection. Within the first two postnatal days, the extent of current prenatal smoke exposure attributable to active smoking of the mother was best reflected by the urinary concentrations of cotinine plus OH-cotinine without adjustment to creatinine.

Keywords

nicotine cotinine trans-3'-hydroxycotinine prenatal smoke exposure pregnant woman neonates urine

References

1 Castles A , Adams FK , Melvin CL , Kelsch C , Boulton ML. Effects of smoking during pregnancy-five meta-analyses . Am J Prev Med 1999; 16: 208-215 .

2 de Jong-Pley EA , Wouters EJ , de Jong PA , Voorhorst FJ , Stolte SB , Kurver PH. Effects of maternal smoking on neonatal morbidity . I Perinat Med 1994; 22: 93-97 .

3 Wang X , Tager IB , Van Vunakis H , Speizer FE , Hanrahan JP. Maternal smoking during pregnancy, urine cotinine concentrations, and birth outcomes. A prospective cohort study . IntJEpidemiol 1997; 26: 978-988 .

4 Schellscheidt J , Jorch G , Menke . Effect of heavy maternal smoking on intrauterine growth pattern in sudden infant death victims and surviving infants . Eur J Pediatr 1998; 157: 246-251 .

5 Schellscheidt J , Oyen N , Jorch G. Interaction between maternal smoking and other prenatal risk factors for sudden infant death syndrome (SIDS) . Acta Paediatr 1997;86: 857-863 .

6 Poets CF , Schlaud M , Kleemann WJ , Rudolph A , Diekmann U , Sens B. Sudden infant death and maternal smoking: result from Lower Saxony Perinatal Working Group . EurJ Pediatr 1995; 154: 326-329 .

7 Nuesslein TG , Becker D , Rieger CHL. Cotinine in meconium indicates risk for early respiratory tract infections . Hum Exp Toxicol 1999;18: 283-290 .

8 Parazzini F , Davoli E , Rabaiotti M , Restelli S , Stramare L , Dindelli M , La Vecchia C , Fanelli R. Validity of self-reported smoking habits in pregnancy: a saliva cotinine analysis . Acta Obstet Gynecol Scand 1996;75: 352-354 .

9 Nafstad P , Kongerud J , Botten G , Urdal P , Silsand T , Pedersen BS , Jaakkola JIJ. Fetal exposure to tobacco smoke products: a comparison between self-reported maternal smoking and concentrations of cotinine and thiocyanate in cord serum . Acta Obstet Gynecol Scand 1996;75: 902-907 .

10.

10 Klebanoff MA , Levine RJ , Clemens JD , DerSimonian R , Wilkins DG. Serum cotinine concentration and self-reported smoking during pregnancy . Am J Epidemiol 1998; 148: 259-262 .%

11.

11 Haddow JE , Knight GJ , Palomaki GE , Kloza EM , Wald NJ. Cigarette consumption and serum cotinine in relation to birthweight . BrJ Obstet Gynaecol 1987; 94: 678-681 .

12.

12 Bardy AH , Seppala T , Lillsunde P , Kataja JM , Koskela P , Pikkrainen J. Objectively measured tobacco exposure during pregnancy: neonatal effects and relation to maternal smoking . Br J Obstet Gynaecol 1993; 100: 721-726 .

13.

13 Eskenazi B , Prehn AW , Christianson RE. Passive and maternal smoking as measured by serum cotinine: effect on birthweight . Am J Public Health 1995; 85: 395-398 .

14.

14 Ostrea EM Jr , Knapp DK , Romero A , Montes M , Ostrea AR. Meconium analysis to assess fetal exposure to nicotine by active and passive maternal smoking . J Pediatr 1994; 124: 471-476 .

15.

15 Luck W , Nau H , Hansen R , Steldinger R. Extent of nicotine and cotinine transfer to human fetus, placenta and amniotic fluid of smoking mothers . Dev Pharmacol Ther 1985;8: 384-395 .

16.

16 Eliopoulos C , Klein J , Phan MK , Knie B , Greenwald M , Chitayat D , Koren G. Hair concentrations of nicotine and cotinine in women and their newborn infants . JAMA 1994; 271: 621-623 .

17.

17 Kintz P , Margin P. Evidence of gestational heroin or nicotine exposure by analysis of fetal hair . Forensic Sci Int 1993; 63: 99-104 .

18.

18 Jordanov SJ. Cotinine concentrations in amniotic fluid and urine of smoking, passive smoking and non-smoking pregnant women at term and in urine of their neonates on 1st day of life . EurJPediatr 1990; 149: 734-737 .

19.

19 Parviainen MT , Barlow RD. Assessment of exposure to environmental tobacco smoke using a high-performance liquid chromatographic method for the simultaneous determination of nicotine and two of its metabolites in urine . J Chromatogr 1988; 431: 216-221 .

20.

20 Helger R , Rindfrey H , Hilgefeld J. Eine Methode zur direkten Bestimmung des Creatinins im Serum und Urin ohne Enteiweilung nach einer modifizierten Jaffé-Methode . Z Klin Chem Kin Biochem 1974; 12: 344-349 .

21.

21 Kohler E , Sollich V , Schuster R , Thal W. Passive smoke exposure in infants and children with respiratory tract diseases . Hum Exp Toxicol 1999; 18: 212-217 .

22.

22 Scherer G , Jarczyk L , Heller WD , et al. Pharmacokinetics of nicotine, cotinine, and 3'-hydroxycotinine in cigarette smokers . Klin Wochenschr 1988; 66 (suppl XI): 5-11 .

23.

23 Langone JJ , Gjika HB , Van Vanukis H. Nicotine and its metabolites: radioimmunoassays for nicotine and cotinine . Biochemistry 1973; 12: 5025-5030 .

24.

24 Thompson SG , Barlow RD , Wald NJ , et al. How should urinary cotinine concentration be adjusted for urinary creatinine concentration? Clin Chim Acta 1990; 187: 289-296 .

25.

25 Haddow JE , Knight GJ , Palomaki GE , Neveux LM , Chilmonczyk BA. Replacing creatinine measurements with specific gravity values to adjust urine cotinine concentrations . Clin Chem 1994; 40: 562-564 .

26.

26 Feyerabend C , Bryant AE , Jarvis MJ. Determination of cotinine in biological fluids of non-smokers by packed column gas-liquid chromatography . J Pharm Pharmacol 1986; 38: 917-919 .

27.

27 Etzel RA , Greenberg RA , Haley Loda FA. Urine cotinine excretion in neonates exposed to tobacco smoke products in utero . J Pediatr 1985; 107: 146-148 .

28.

28 Dempsey D , Jacob P , Benowitz NL. Nicotine metabolism and elimination kinetics in newborns . Clin Pharmacol Ther 2000; 67: 458-465 .

29.

29 Schulte-Hobein B , Schwartz-Birkenbach D , Abt S , Plum C , Nau H. Cigarette smoke exposure and development of infants throughout the first year of life: influence of passive smoking and nursing on cotinine levels in breast milk and infants urine . Acta Paediatr 1992; 81: 500-507 .

30.

30 Neurath GB , Dunger M , Orth D , Pein G. Trans-3'-hydroxycotinine as main metabolite in urine of smokers . Int Arch Occup Environ Health 1987; 59: 199-201 .

31.

31 Willers S , Scarping G , Dalene M , et al. Urinary cotinine in children and adults during and after semiexperimental exposure to environmental tobacco smoke . Arch Environ Health 1995; 50: 130-138 .

32.

32 O'Connor TZ , Holford TR , Leaderer BP , Hammond SK , Bracken MB. Measurement of exposure to environmental tobacco smoke in pregnant women . Am J Epidemiol 1995; 142: 1315-1321 .