TY - JOUR
T1 - Serum Cotinine and Adverse Cardiovascular Outcomes
T2 - A Cross-sectional Secondary Analysis of the nuMoM2b Heart Health Study
AU - Theilen, Lauren H.
AU - McNeil, Rebecca B.
AU - Hunter, Shannon
AU - Grobman, William A.
AU - Parker, Corette B.
AU - Catov, Janet M.
AU - Pemberton, Victoria L.
AU - Ehrenthal, Deborah B.
AU - Haas, David M.
AU - Hoffman, Matthew K.
AU - Chung, Judith H.
AU - Mukhtar, Farhana
AU - Arzumanyan, Zorayr
AU - Mercer, Brian
AU - Parry, Samuel
AU - Saade, George R.
AU - Simhan, Hyagriv N.
AU - Wapner, Ronald J.
AU - Silver, Robert M.
N1 - Funding Information:
H.N.S. reports grants from National Institutes of Health during the conduct of the study. B.M. reports grants from National Institutes of Health during the conduct of the study. M.K.H. reports grants from National Institute of Child Health and Human Development during the conduct of the study. C.B.P. reports grants from National Institutes of Health/National Heart, Lung, and Blood Institute during the conduct of the study. S.H. reports grants from National Heart, Lung, and Blood Institute, grants from Eunice Kennedy Shriver National Institute of Child Health and Human Development during the conduct of the study. R.B.M. reports grants from National Institutes of Health/National Heart, Lung, and Blood Institute during the conduct of the study. L.H.T. reports grants from American Association of Obstetricians and Gynecologists Foundation Scholar Award, from null, outside the submitted work.
Funding Information:
This work was supported by grants (cooperative agreements) from the National Heart, Lung, and Blood Institute and the Eunice Kennedy Shriver National Institute of Child Health and Human Development: U01-HL145358; U10-HL119991; U10-HL119989; U10-HL120034; U10-HL119990; U10-HL120006; U10-HL119992; U10-HL120019; U10-HL119993; and U10-HL120018. Support was also provided by the National Institutes of Health: Office of Disease Prevention; Office of Research on Women’s Health; Office of Behavioral and Social Sciences Research; and the National Center for Advancing Translational Sciences – UL-1-TR000124, UL-1-TR000153, UL-1-TR000439, and UL-1-TR001108. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2021 Thieme Medical Publishers, Inc.. All rights reserved.
PY - 2021/5/14
Y1 - 2021/5/14
N2 - Objective ?We aimed to (1) compare serum cotinine with self-report for ascertaining smoking status among reproductive-aged women; (2) estimate the relative odds of adverse cardiovascular (CV) outcomes among women by smoking status; (3) assess whether the association between adverse pregnancy outcomes (APOs) and CV outcomes varies by smoking status. Study Design ?We conducted a cross-sectional study of the nuMoM2b Heart Health Study. Women attended a study visit 2 to 7 years after their first pregnancy. The exposure was smoking status, determined by self-report and by serum cotinine. Outcomes included incident chronic hypertension (HTN), metabolic syndrome (MetS), and dyslipidemia. Multivariable logistic regression estimated odds ratios (ORs) for each outcome by smoking status. Results ?Of 4,392 women with serum cotinine measured, 3,610 were categorized as nonsmokers, 62 as secondhand smoke exposure, and 720 as smokers. Of 3,144 women who denied tobacco smoke exposure, serum cotinine was consistent with secondhand smoke exposure in 48 (1.5%) and current smoking in 131 (4.2%) After adjustment for APOs, smoking defined by serum cotinine was associated with MetS (adjusted OR [aOR] = 1.52, 95% confidence interval [CI]: 1.21, 1.91) and dyslipidemia (aOR = 1.28, 95% CI: 1.01, 1.62). When stratified by nicotine exposure, nonsmokers with an APO in their index pregnancy had higher odds of stage 1 (aOR = 1.64, 95% CI: 1.32, 2.03) and stage 2 HTN (aOR = 2.92, 95% CI: 2.17, 3.93), MetS (aOR = 1.76, 95% CI: 1.42, 2.18), and dyslipidemia (aOR = 1.55, 95% CI: 1.25, 1.91) relative to women with no APO. Results were similar when smoking exposure was defined by self-report. Conclusion ?Whether determined by serum cotinine or self-report, smoking is associated with subsequent CV outcomes in reproductive-aged women. APOs are also independently associated with CV outcomes in women. Key Points Cotinine was detected in 5.7% of reported nonsmokers. Smoking and APOs were independently associated with CV health. Smoking was associated with MetS and dyslipidemia.
AB - Objective ?We aimed to (1) compare serum cotinine with self-report for ascertaining smoking status among reproductive-aged women; (2) estimate the relative odds of adverse cardiovascular (CV) outcomes among women by smoking status; (3) assess whether the association between adverse pregnancy outcomes (APOs) and CV outcomes varies by smoking status. Study Design ?We conducted a cross-sectional study of the nuMoM2b Heart Health Study. Women attended a study visit 2 to 7 years after their first pregnancy. The exposure was smoking status, determined by self-report and by serum cotinine. Outcomes included incident chronic hypertension (HTN), metabolic syndrome (MetS), and dyslipidemia. Multivariable logistic regression estimated odds ratios (ORs) for each outcome by smoking status. Results ?Of 4,392 women with serum cotinine measured, 3,610 were categorized as nonsmokers, 62 as secondhand smoke exposure, and 720 as smokers. Of 3,144 women who denied tobacco smoke exposure, serum cotinine was consistent with secondhand smoke exposure in 48 (1.5%) and current smoking in 131 (4.2%) After adjustment for APOs, smoking defined by serum cotinine was associated with MetS (adjusted OR [aOR] = 1.52, 95% confidence interval [CI]: 1.21, 1.91) and dyslipidemia (aOR = 1.28, 95% CI: 1.01, 1.62). When stratified by nicotine exposure, nonsmokers with an APO in their index pregnancy had higher odds of stage 1 (aOR = 1.64, 95% CI: 1.32, 2.03) and stage 2 HTN (aOR = 2.92, 95% CI: 2.17, 3.93), MetS (aOR = 1.76, 95% CI: 1.42, 2.18), and dyslipidemia (aOR = 1.55, 95% CI: 1.25, 1.91) relative to women with no APO. Results were similar when smoking exposure was defined by self-report. Conclusion ?Whether determined by serum cotinine or self-report, smoking is associated with subsequent CV outcomes in reproductive-aged women. APOs are also independently associated with CV outcomes in women. Key Points Cotinine was detected in 5.7% of reported nonsmokers. Smoking and APOs were independently associated with CV health. Smoking was associated with MetS and dyslipidemia.
KW - cardiovascular diseases
KW - cross-sectional studies
KW - nicotine
KW - pregnancy
KW - pregnancy outcome
KW - smokers
KW - tobacco smoke
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U2 - 10.1055/a-1580-3155
DO - 10.1055/a-1580-3155
M3 - Article
C2 - 34359079
AN - SCOPUS:85116916916
SN - 0735-1631
VL - 40
SP - 1311
EP - 1320
JO - American journal of perinatology
JF - American journal of perinatology
IS - 12
ER -
