Nicotine and metabolites in meconium as evidence of maternal cigarette smoking during pregnancy and predictors of neonatal growth deficits

Teresa R. Gray, Rina D. Eiden, Kenneth E. Leonard, Gerard Connors, Shannon Shisler, Marilyn A. Huestis

Research output: Contribution to journalArticlepeer-review

53 Scopus citations


Introduction: Many women continue tobacco use during pregnancy despite known adverse consequences on neonatal growth and development. Testing meconium, the first neonatal feces, for tobacco biomarkers offers objective evidence of prenatal tobacco exposure. However, relationships between the amount, frequency, and timing of cigarette smoking during gestation and tobacco biomarker meconium concentrations and neonatal outcomes are unclear. Methods: Eighty-seven pregnant women provided detailed self-reports of daily tobacco consumption throughout pregnancy. Nicotine, cotinine, and trans-3′-hydroxycotinine were quantified in neonatal meconium by liquid chromatography-tandem mass spectrometry. Results: Among nonsmokers, all meconium specimens were negative, whereas nearly all meconium specimens were positive if the mother self-reported tobacco use into the third trimester. Tobacco biomarker concentrations were significantly albeit weakly correlated with mean cigarettes per day in the third trimester. Reduced birth weight, gestational age, or head circumference were observed if meconium contained one or more tobacco biomarkers, but deficits did not correlate with biomarker concentrations. Conclusion: While previously thought to reflect second and third trimester drug exposure, meconium appears to reliably identify only third trimester drug use. While a 10 ng/g nicotine, cotinine, or trans-3′-hydroxycotinine cutoff in meconium was previously proposed to differentiate tobacco-exposed from nonexposed or passively exposed neonates, improved maternal self-reporting techniques in this cohort suggest that a lower cutoff, equivalent to the analytic limits of quantification, is more appropriate. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2010.

Original languageEnglish (US)
Pages (from-to)658-664
Number of pages7
JournalNicotine and Tobacco Research
Issue number6
StatePublished - Apr 28 2010

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health


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