Cord serum cotinine as a biomarker of fetal exposure to cigarette smoke at the end of pregnancy

S Pichini, X B Basagaña, R Pacifici, O Garcia, C Puig, O Vall, Jessica M Harris, P Zuccaro, J Segura, J Sunyer

Research output: Contribution to journalArticle (Academic Journal)peer-review

119 Citations (Scopus)


This study investigated the association between biomarkers of fetal exposure to cigarette smoke at the end of pregnancy, cotinine in cord serum and in maternal and newborn urine samples, and quantitative measurement of smoking intake and exposure evaluated by maternal self-reported questionnaire. Study subjects were 429 mothers and their newborns from a hospital in Barcelona, Spain. A questionnaire including smoking habits was completed in the third trimester of pregnancy and on the day of delivery. Cotinine concentration in cord serum was associated with daily exposure to nicotine in nonsmokers and with daily nicotine intake in smokers. The geometric mean of cotinine concentration in cord serum statistically discriminated between newborns from nonexposed and exposed nonsmoking mothers, and between these two classes and smokers, and furthermore was able to differentiate levels of exposure to tobacco smoke and levels of intake stratified in tertiles. Urinary cotinine levels in newborns from nonsmoking mothers exposed to more than 4 mg nicotine daily were statistically different from levels in two other categories of exposure. Cotinine concentration in urine from newborns and from mothers did not differentiate between exposure and nonexposure to environmental tobacco smoke (ETS) in nonsmoking mothers. Cord serum cotinine appeared to be the most adequate biomarker of fetal exposure to smoking at the end of pregnancy, distinguishing not only active smoking from passive smoking, but also exposure to ETS from nonexposure.

Original languageEnglish
Pages (from-to)1079-83
Number of pages5
JournalEnvironmental Health Perspectives
Issue number11
Publication statusPublished - Nov 2000


  • Adult
  • Biological Markers
  • Cotinine
  • Environmental Exposure
  • Female
  • Fetal Blood
  • Humans
  • Infant, Newborn
  • Male
  • Maternal-Fetal Exchange
  • Pregnancy
  • Questionnaires
  • Smoking
  • Spain
  • Tobacco Smoke Pollution


Dive into the research topics of 'Cord serum cotinine as a biomarker of fetal exposure to cigarette smoke at the end of pregnancy'. Together they form a unique fingerprint.

Cite this