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Ascertainment of environmental tobacco exposure in pregnancy

Institution: Sequoia Foundation
Investigator(s): Martin Kharrazi, Ph.D.
Award Cycle: 1999 (Cycle 8) Grant #: 8RT-0115 Award: $2,053,747
Subject Area: Epidemiology
Award Type: Research Project Awards
Abstracts

Initial Award Abstract
Even though it is well-known that the health of pregnant women and their newborn offspring is damaged be tobacco smoke, little is known about who in California is exposed to tobacco smoke during pregnancy, for how long and how much. One reason for this is that California is the only state that does not have a smoking question as part of its birth certificate.

The objectives of this research project are to put together a source of information to answer these and other questions about smoking. We will work together with other programs of the California Department of Health Services, the National Centers for Disease Control and Prevention (CDC), the San Diego County Health Department, 20 delivery hospitals, area medical laboratories, and numerous community clinics and doctors to do this.

We will collect information from pregnant women in San Diego County during 1999-2001. Blood and urine taken from pregnant women for non-study reasons and which is left over after analysis wil1 be collected by the study, stored and later used to measure how much tobacco smoke these women were exposed to. We will obtain the blood and urine at three points in the pregnancy: at the time each woman goes in for a pregnancy test at a lab or doctors' office, at 15 19 weeks gestation when she gives blood to be screened for certain birth defects, and at birth when umbilical cord blood is taken at the hospital. While at the hospital for delivery, the mother will be asked to answer a short questionnaire (in Spanish or English) about her smoking history and her exposure to others who were smoking during the pregnancy. Participation in the study is voluntary and necessary approvals from women will be obtained for all collection activities.

Over a 19-month period, we plan to collect approximately 40,000 maternal urine or serum samples collected early in pregnancy, 60,000 maternal serum samples collected in the second trimester, and 50,000 umbilical cord blood samples, live birth records and questionnaires collected at the time of the birth. Approximately 6,000 blood and urine samples from over 2,000 women will be selected and sent to a special national lab for analysis. Levels of a tobacco metabolite (cotinine) in a woman's blood or urine will be measured to find out how much tobacco she and her baby were exposed to, either by smoking or by being around others who smoke.

Once all of these data are linked together, we will be able to: 1) define the true pattern of tobacco smoke exposure across the nine months of pregnancy; 2) determine the characteristics of women who are most exposed to tobacco smoke; and 3) determine which of two smoking questions women most accurately respond to. If we can scientifically validate at least one of the smoking questions, then it will be recommended for use on future California birth certificates. The results of this study will be helpful in informing future research efforts as well as in shaping policies to prevent the health of pregnant women and their newborns from being damaged by tobacco smoke.
Publications

Impact of different smoking questions on rates of smoking during pregnancy
Periodical: American Journal of Epidemiology Index Medicus:
Authors: Kharrazi M, DeLorenze GN, Pearl M, Domdom D, Marzullo M, Graham S, Pang J, Epstein D ABS
Yr: 2003 Vol: 157 Nbr: Abs: Pg: S61

Feasibility of ascertaining time-to-pregnancy among women obtaining clinical pregnancy confirmation.
Periodical: American Journal of Epidemiology Index Medicus:
Authors: Pearl M, Kharrazi M, DeLorenze GN, Domdom D, Caves J, Marzullo MA, Hubbard A ABS
Yr: 2003 Vol: 157 Nbr: Abs: Pg: S61