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Accuracy of self‐reported smoking status in first trimester aneuploidy screening
Author(s) -
Spencer Kevin,
Cowans Nicholas J.
Publication year - 2013
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4053
Subject(s) - cotinine , medicine , aneuploidy , pregnancy , obstetrics , down syndrome , human chorionic gonadotropin , gynecology , population , first trimester , second trimester , pregnancy associated plasma protein a , trisomy , nicotine , gestation , biology , environmental health , hormone , psychiatry , biochemistry , chromosome , gene , genetics
Objectives To review the accuracy of self‐reporting of smoking status in our first trimester screening population and to assess the levels of pregnancy‐associated plasma protein‐A (PAPP‐A) and free‐β human chorionic gonadotropin (free‐hCGβ) in women who were classified for smoking status by serum cotinine concentrations and self‐reporting. Methods Cotinine concentration was determined in the stored serum 696 self‐reported smokers and 442 self‐reported non‐smokers. PAPP‐A and free‐hCGβ multiples of the medians (MoMs) determined at screening were reverted to uncorrected for self‐reported smoking status. Results A total of 21.7% of those self‐reporting as non‐smokers had increased serum cotinine concentrations (using a cut‐off of 13.7 ng/mL), indicating a positive smoking status. This under‐reporting meant that serum PAPP‐A and free‐hCGβ MoMs were greater reduced in smokers classified by cotinine levels (17.2% and 9.7%) than in those classified by self‐reporting (14.6% and 2.8%). Women who were classified as smokers at conception but had stopped at some time afterwards did not have significantly reduced marker MoMs to non‐smokers. Conclusions Self‐reporting results in under‐representation of smoking in our population, resulting in a significant bias and inflated screen‐positive rates. © 2013 John Wiley & Sons, Ltd.