A prospective, observational study investigating the use of carbon monoxide screening to identify maternal smoking in a large university hospital in Ireland

Title: A prospective, observational study investigating the use of carbon monoxide screening to identify maternal smoking in a large university hospital in Ireland
Authors: Reynolds, Ciara Marie Edel
Egan, Brendan
Kennedy, Rachel A.K.
O'Malley, Eimer G.
Sheehan, Sharon R
Turner, Michael J.
Permanent link: http://hdl.handle.net/10197/10480
Date: 23-Jul-2018
Online since: 2019-05-16T07:34:27Z
Abstract: Objectives: This study evaluated breath carbon monoxide (BCO) testing in identifying maternal smokers as well as the difference between disclosers and non-disclosers of smoking status. We also investigated if other extrinsic factors affected the women's BCO levels in pregnancy. Design A prospective observational study. Setting: A university obstetric hospital in an urban setting in Ireland. Participants Women (n=250) and their partners (n=54) were recruited at their first antenatal visit. Women <18 years and those who did not understand English were excluded. A booking history, including recording of smoking status, was collected by midwives. Following this, women were recruited and completed a detailed research questionnaire on smoking and extrinsic/ environmental BCO sources. A BCO test was performed on both the woman and her partner. Primary and secondary outcome measures The number of self-reported smokers and those that were positive on the BCO test. The characteristics of women who disclosed and did not disclose smoking status. The effect of extrinsic factors on the BCO test results. Results: Based on the receiver-operating characteristic curve, a BCO cut-off point of ≥3 ppm was the optimal level to identify ongoing smoking. At booking history, 15% of women reported as current smokers. Based on BCO levels ≥3 ppm combined with self-reported smoking in the research questionnaire, the rate increased to 25%. Non-disclosers had similar characteristics to non-smokers. No extrinsic factors affected maternal BCO levels. Conclusions: Based on self-report and BCO levels, a quarter of women presenting for antenatal care continued to smoke, but only 60% reported their smoking to midwives. BCO measurement is an inexpensive, practical method of improving identification of maternal smoking, and it was not effected by extrinsic sources of BCO. Improved identification means more smokers can be supported to stop smoking in early pregnancy potentially improving the short-term and long-term health of both mother and child.
Type of material: Journal Article
Publisher: BMJ
Journal: BMJ Open
Volume: 8
Issue: 7
Copyright (published version): 2018 the Authors
Keywords: Carbon monoxideNon-disclosurePregnancyScreeningSmokingBreath carbon monoxide (BCO) testing
DOI: 10.1136/bmjopen-2018-022089
Language: en
Status of Item: Peer reviewed
Appears in Collections:Medicine Research Collection
Public Health, Physiotherapy and Sports Science Research Collection

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