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Acta Obstet Gynecol Scand. 2010 Dec;89(12):1538-44. doi: 10.3109/00016349.2010.526187. Epub 2010 Nov 5.

Self-reported smoking habits and serum cotinine levels in women with placental abruption.

Author information

1
Department of Obstetrics and Gynecology, University Central Hospital, Helsinki, Finland. minna.tikkanen@hus.fi

Abstract

OBJECTIVE:

smoking is an important risk factor for placental abruption with strong dose-dependency. Pregnant smokers often underreport tobacco use which can be objectively assessed by measuring serum cotinine levels. We examined the accuracy between self-reported smoking habits and early pregnancy serum cotinine levels in women with or without placental abruption.

DESIGN:

retrospective case-control study.

SETTING:

university Hospital.

POPULATION:

a total of 175 women with placental abruption and 370 control women.

METHODS:

serum samples collected during the first trimester were analyzed for serum cotinine levels. Cotinine concentration over 15 ng/ml was considered as the cutoff indicating active smoking. Smoking habits of the women and their partners were recorded at the same visit.

MAIN OUTCOME MEASURE:

placental abruption.

RESULTS:

of the cases of women with placental abruption, 27.4% reported smoking compared with 14.3% of the controls (p < 0.001). Based on serum cotinine levels, 30.3% of the case women and 17.6% of the control women were considered smokers (p = 0.003). Serum cotinine levels among smokers were higher in the abruption group than in the control group (median 229.5 ng/ml (interquartile range 169.8-418.1) vs. 153.5 ng/ml (56.6-241.4), p = 0.002). Self-reported number of cigarettes smoked daily correlated well with the cotinine levels (r = 0.68, p < 0.001). Of the women reporting as nonsmokers, approximately 7% were considered smokers based on cotinine testing.

CONCLUSION:

pregnant women with subsequent placental abruption are heavier smokers than pregnant control women. Self-reported smoking habits correlate well with serum cotinine levels in Finland. Therefore, self-reported smoking can be considered as a risk marker for placental abruption.

Comment in

PMID:
21050148
DOI:
10.3109/00016349.2010.526187
[Indexed for MEDLINE]

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