Evaluating association of smoking status during pregnancy with adverse birth outcomes using urinary cotinine concentration: The Japan environment and Children's study (JECS)

doi:10.1016/j.envres.2022.114302

. 2022 Dec;215(Pt 2):114302.

doi: 10.1016/j.envres.2022.114302. Epub 2022 Sep 15.

Evaluating association of smoking status during pregnancy with adverse birth outcomes using urinary cotinine concentration: The Japan environment and Children's study (JECS)

Affiliations

¹ Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, 1-1-1, Midorigaoka Higashi2-jo, Asahikawa, Hokkaido, 078-8510, Japan.
² Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, 1-1-1, Midorigaoka Higashi2-jo, Asahikawa, Hokkaido, 078-8510, Japan. Electronic address: y-saijo@asahikawa-med.ac.jp.
³ Division of Hygiene and Health Science, Department of Social Medicine, Asahikawa Medical University, 1-1-1, Midorigaoka Higashi2-jo, Asahikawa, Hokkaido, 078-8510, Japan.
⁴ Department of Obstetrics and Gynecology, Asahikawa Medical University, 1-1-1, Midorigaoka Higashi2-jo, Asahikawa, Hokkaido, 078-8510, Japan.
⁵ Division of Neonatology, The Center for Maternity and Infant Care, Asahikawa Medical University Hospital, 1-1-1, Midorigaoka Higashi2-jo, Asahikawa, Hokkaido, 078-8510, Japan.
⁶ Department of Pediatrics, Asahikawa Medical University, 1-1-1, Midorigaoka Higashi2-jo, Asahikawa, Hokkaido, 078-8510, Japan.
⁷ Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, 664-1, Akebono-cho, Kitami, Hokkaido, 090-0011, Japan.
⁸ Center for Environmental and Health Sciences, Hokkaido University, Kita12-jo, Nishi7-chome, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.
⁹ Center for Environmental and Health Sciences, Hokkaido University, Kita12-jo, Nishi7-chome, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan; Faculty of Health Sciences, Hokkaido University, Kita12-jo, Nishi5-chome, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.

PMID: 36115418
DOI: 10.1016/j.envres.2022.114302

Free article

Evaluating association of smoking status during pregnancy with adverse birth outcomes using urinary cotinine concentration: The Japan environment and Children's study (JECS)

Yuki Kunori et al. Environ Res. 2022 Dec.

Free article

. 2022 Dec;215(Pt 2):114302.

doi: 10.1016/j.envres.2022.114302. Epub 2022 Sep 15.

Authors

Affiliations

¹ Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, 1-1-1, Midorigaoka Higashi2-jo, Asahikawa, Hokkaido, 078-8510, Japan.
² Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, 1-1-1, Midorigaoka Higashi2-jo, Asahikawa, Hokkaido, 078-8510, Japan. Electronic address: y-saijo@asahikawa-med.ac.jp.
³ Division of Hygiene and Health Science, Department of Social Medicine, Asahikawa Medical University, 1-1-1, Midorigaoka Higashi2-jo, Asahikawa, Hokkaido, 078-8510, Japan.
⁴ Department of Obstetrics and Gynecology, Asahikawa Medical University, 1-1-1, Midorigaoka Higashi2-jo, Asahikawa, Hokkaido, 078-8510, Japan.
⁵ Division of Neonatology, The Center for Maternity and Infant Care, Asahikawa Medical University Hospital, 1-1-1, Midorigaoka Higashi2-jo, Asahikawa, Hokkaido, 078-8510, Japan.
⁶ Department of Pediatrics, Asahikawa Medical University, 1-1-1, Midorigaoka Higashi2-jo, Asahikawa, Hokkaido, 078-8510, Japan.
⁷ Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, 664-1, Akebono-cho, Kitami, Hokkaido, 090-0011, Japan.
⁸ Center for Environmental and Health Sciences, Hokkaido University, Kita12-jo, Nishi7-chome, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.
⁹ Center for Environmental and Health Sciences, Hokkaido University, Kita12-jo, Nishi7-chome, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan; Faculty of Health Sciences, Hokkaido University, Kita12-jo, Nishi5-chome, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.

PMID: 36115418
DOI: 10.1016/j.envres.2022.114302

Abstract

Urinary cotinine concentration (UCC) reflects smoking status. However, in pregnant women, its association with adverse birth outcomes related to fetal growth is not widely known. Thus, we aimed to explore this relationship by focusing on dose-response relationships. We investigated 86,638 pregnant women enrolled between 2011 and 2014 in a prospective cohort study in Japan and observed three birth outcomes (preterm birth, low birth weight, and small-for-gestational age). We measured UCC in the second or third trimester, and categorized the participants using cut-off values (negative cotinine concentration, passive cotinine concentration, and active cotinine concentration corresponding to non-smokers, passive smokers, and active smokers, respectively). Logistic regression analyses were conducted to evaluate the risks, and dose-response relationships were visualized using restricted cubic spline curves. Analyses based on self-reported smoking status were also performed. We found that in low active and highly active cotinine concentrations, the adjusted odds ratios (aORs) of birth outcomes were significantly increased (preterm birth, 1.24 [95% CI 1.06-1.46], 1.39 [95% CI 1.19-1.62]; low birth weight, 1.40 [95% CI 1.24-1.58], 2.27 [95% CI 2.05-2.53]; small-for-gestational age, 1.35 [95% CI 1.19-1.52], 2.39 [95% CI 2.16-2.65]). Restricted cubic spline curves demonstrated risk elevations in the active cotinine concentration range. Our research revealed dose-response relationships between UCC during pregnancy and the risks of preterm birth, low birth weight, and small-for-gestational age. Measurement of UCC to ascertain smoking status during pregnancy may be a useful approach for predicting the risks of these birth outcomes.

Keywords: Low birth weight; Pregnancy; Preterm birth; Small-for-gestational age; Smoking; Urinary cotinine.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Association between urinary cotinine level and hypertensive disorders of pregnancy in women with uterine myoma: findings from the Japan Environment and Children's Study.
Kyozuka H, Omoto T, Murata T, Fukuda T, Okoshi C, Isogami H, Yasuda S, Sato A, Ogata Y, Hosoya M, Yasumura S, Hashimoto K, Fujimori K, Nishigori H; Japan Environment and Children’s Study (JECS) Group. Kyozuka H, et al. Hypertens Res. 2025 Jan;48(1):102-109. doi: 10.1038/s41440-024-01971-6. Epub 2024 Nov 1. Hypertens Res. 2025. PMID: 39487317

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Evaluating association of smoking status during pregnancy with adverse birth outcomes using urinary cotinine concentration: The Japan environment and Children's study (JECS)

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Evaluating association of smoking status during pregnancy with adverse birth outcomes using urinary cotinine concentration: The Japan environment and Children's study (JECS)

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