Prevalence of second-hand smoking and urinary cotinine in pregnant women

Soontron Srituee, Nisa Sriwong, Wisut Kangwantrakul, Jindarat Trakulthong, Limthong Promdee


Second-hand smoke exposure in pregnant women may increase fetal heart rate, reduce birth weight and associate with allergies during preschool. This study was aimed to determine the prevalence of second-hand smoking in pregnant women by questionnaire and detection of urinary cotinine to creatinine ratio (CCR). The study was performed in 242 pregnant women who attended prenatal care unit at Phuthachinaratana Hospital. The subjects were divided into two groups based on the data from questionnaire: non-smoker non exposed (n = 20; 8.2%), and second-hand smoker (n = 222; 91.7%). The number of second-hand smoker pregnant women in trimester 1, 2, and 3 were 76 (31%), 75 (30%), and 71 (29%), respectively. Positive CCR was found in 26 second-hand smokers, of which 15, 9 and 2 were in trimester 1, 2, and 3, respectively. To determine the effects of social status on second-hand smoke exposure and positive CCR, odd ratio was analyzed. It was found that living outside the municipal area was the risk factor for second-hand smoke exposure with OR 3.11 (95% CI 1.19-8.45, p <0.015). Increasing gestational age increased negative effect on second-hand smoke exposure. The results showed lower risk of smoke exposure with OR 0.1 (95% CI 0.01-0.48, p <0.001) compared with the first trimester. The results demonstrated high prevalence of second-hand smoking in pregnant Thai women. Thus there should be a campaign to reduce maternal second-hand smoking so as to reduce potential adverse effects on the fetus.

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