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Agreement of umbilical cord drug and cotinine levels with maternal self-report of drug use and smoking during pregnancy

Journal of Perinatology volume 32, pages 156–157 (2012)Cite this article

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We thank Garcia-Algar et al.1 for their interest in our recent work. We agree with their conclusions that cord serum is a reliable indicator of smoke exposure, both direct and environmental. We specifically developed our method assaying umbilical cord tissue to assess smoke exposure when cord serum is not available, especially for histological comparisons of placental pathology.

In addition, we did not suggest that umbilical cord tissue would act as a reservoir for cotinine when we discussed the physicochemistry of cotinine and the makeup of the umbilical tissue. The pharmacokinetic flow of cotinine with respect to mom's blood, placenta, umbilical tissue and fetal blood is not fully elucidated. Hence, cotinine, having a longer half-life than nicotine, is still detectable in the tissue and may be indicative of smoke exposure, but not quantitative for amounts of exposure. Cord serum can be used to quantitate the amount of exposure, and when available may be superior. There are times, however, when cord serum is not available, as it was not collected. Our method provides a means to assess tobacco exposure in those cases when the placenta and cord are available but not the serum.

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References

  1. Garcia-Algar O, Puig C, Pichini S, Pallas K, Vall O . Umbilical cord blood cotinine and smoking during pregnancy. J Perinatol 2012; 32: 156.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Women's Health, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA

    T E Wright & A Collier

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  1. T E Wright
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  2. A Collier
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Correspondence to T E Wright.

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Wright, T., Collier, A. Agreement of umbilical cord drug and cotinine levels with maternal self-report of drug use and smoking during pregnancy. J Perinatol 32, 156–157 (2012). https://doi.org/10.1038/jp.2011.95

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