Tobacco Exposure in Pregnant Women in Minority Populations

Project Timeline: 7/1/2004 - 6/30/2007

Active and secondhand smoke (SHS) cause low birth weight, miscarriage, preterm birth, fetal and infant death, as well as other adverse pregnancy outcomes. Pregnant women, especially those of minority populations, are priority population for tobacco control in California. However, no objective data exist on the extent of tobacco exposure among minority pregnant women in California. This study used a biological measure - serum cotinine, a metabolite of nicotine found in blood - to assess active smoke and SHS exposure levels during mid-pregnancy in ten minority populations (Native Americans, Chinese, Japanese, Koreans, Filipinos, Cambodians, Vietnamese, Laotians, Asian Indians, and Samoans), compared to cotinine levels in pregnant Mexican Hispanics, Whites, and Blacks.

The study population was made up of 3966 women were enrolled in California's Prenatal Screening Program between 2000 and 2002, is prenatal care providers were located in the southern most part of California in Orange, San Diego, and Imperial counties, and whose blood was saved and frozen after testing and one of the state’s regional prenatal screening laboratories. Approximately 75% of all women delivering live births enrolled in the prenatal screening program during these years. Minority populations that showed a low smoking rate mid-pregnancy any concomitant low exposure to SHS were Chinese, Filipinos, and Laotians. Other minority populations that had a low or mid-level smoking rates and comparatively high exposure to SHS were Asian Indians, Vietnamese, and Cambodians, as well as Hispanics. These are groups in whose steps to protect pregnant women from SHS were likely not in place or ineffective. This is a steep contrast to whites who have high rates of smoking yet very low SHS exposure. In this study population, mean infant birth weight went down by 41 grams per log increase in cotinine when selected confounders were controlled. We conducted analysis determine if there was any evidence to suggest that SHS lowered mean birth weight more than one minority population than another and could not find any important differences between groups. These analyses, however, were limited by small sample size.