Association between self-reported survey measures and biomarkers of second-hand tobacco smoke exposure in non-smoking pregnant women

Meiman Maggie Chen, Su Er Guo, Chi Pin Yuan, Chizimuzo Okoli, Yen Chi Liao

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Second-hand tobacco smoke (SHS) causes adverse health outcomes in adults. Further studies are needed to evaluate psychosocial SHS exposure measures in comparison to SHS exposure biomarkers, particularly in pregnant women. This study aimed to compare self-reported SHS exposure to urinary cotinine levels in pregnant women. A cross-sectional correlation design was conducted using a convenience sample of 70 non-smoking pregnant women. Measures included self-reported questionnaires and laboratory confirmation of cotinine levels in the urinary samples. Mul-tiple regression analysis was used to assess the correlation after controlling for potential confound-ing variables. The average level of urinary cotinine among non-smoking pregnant women was 6.77 ng/mL. Medium-strength correlations were found among psychosocial SHS exposure measures and urine cotinine levels. Questions regarding ‘instances of smoking in front of the individual’ and ‘sub-jective perceived frequency of SHS exposure in past 7 days’ are feasible items for pregnant women in clinics (particularly the first question). Hence, we suggest that these simple questions should be used to assist pregnant women in reducing the harm associated with SHS exposure.

Original languageEnglish
Article number9197
JournalInternational Journal of Environmental Research and Public Health
Issue number17
StatePublished - Sep 1 2021

Bibliographical note

Funding Information:
Funding: This research was financially supported by the Ditmanson Medical Foundation Chia-Yi Christian Hospital, grant number SCRPFG031 and Chang Gung University of Science and Technology, grant number ZRRPF6J0011.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.


  • Biomarkers
  • Environmental tobacco smoke exposure
  • Pregnant women
  • Urine cotinine

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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