Comparison of prenatal self-report of tobacco use to direct measurement of umbilical cord cotinine
Abstract 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.
Authors
- Brenda Bradley Poindexter (ORCID: https://orcid.org/0000-0002-1013-9896)
- Stephanie L. Merhar (ORCID: https://orcid.org/0000-0002-3331-4220)
- Deanne E. Wilson-Costello (ORCID: https://orcid.org/0000-0003-3709-2706)
- Hongying Daisy Dai (ORCID: https://orcid.org/0000-0003-1395-7904)
- Jamie E. Newman (ORCID: https://orcid.org/0000-0001-8880-8132)
- Catherine Limperopoulos (ORCID: https://orcid.org/0000-0003-1735-0069)
- Sara B. DeMauro (ORCID: https://orcid.org/0000-0003-1647-4000)
- Namasivayam Ambalavanan (ORCID: https://orcid.org/0000-0003-0731-9092)
- E. Melinda Mahabee‐Gittens (ORCID: https://orcid.org/0000-0002-3893-885X)
- Carla Bann (ORCID: https://orcid.org/0000-0001-9305-8305)
- Scott A. Lorch (ORCID: https://orcid.org/0000-0003-3855-6752)
- K D Setchell
- Lara Stone (ORCID: https://orcid.org/0000-0002-6978-892X)
- Myriam Peralta-Carcelén (ORCID: https://orcid.org/0009-0000-0960-380X)
- Nicole Mack
- Jonathan M. Davis
- Junfang Zhao
Institutions
- Cincinnati Children's Hospital Medical Center (US)
- Tufts Medical Center (US)
- Children's Hospital of Philadelphia (US)
- Children's National (US)
- Emory University (US)
- RTI International (US)
- University of Nebraska System (US)
- University of Alabama at Birmingham (US)
- Perinatal Institute (GB)
- Case Western Reserve University (US)
- University of Cincinnati (US)
- University of Cincinnati Medical Center (US)
Publication Details
- Journal
- Journal of Perinatology
- Published
- 2026-10-07
- DOI
- https://doi.org/10.1038/s41372-026-02902-8
- Primary Topic
- Smoking Behavior and Cessation
- Type
- article
- Field-Weighted Citation Impact
- 0.00