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首页> 外文期刊>Addictive behaviors >Using expired air carbon monoxide to determine smoking status during pregnancy: Preliminary identification of an appropriately sensitive and specific cut-point
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Using expired air carbon monoxide to determine smoking status during pregnancy: Preliminary identification of an appropriately sensitive and specific cut-point

机译：使用过期的一氧化碳确定怀孕期间的吸烟状况：初步确定适当敏感和特定的临界点

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Background: Measurement of carbon monoxide in expired air samples (ECO) is a non-invasive, cost-effective biochemical marker for smoking. Cut points of 6. ppm-10. ppm have been established, though appropriate cut-points for pregnant woman have been debated due to metabolic changes. This study assessed whether an ECO cut-point identifying at least 90% of pregnant smokers, and misidentifying fewer than 10% of non-smokers, could be established. Methods: Pregnant women (N=167) completed a validated self-report smoking assessment, a urine drug screen for cotinine (UDS), and provided an expired air sample twice during pregnancy. Results: Half of women reported non-smoking status early (51%) and late (53%) in pregnancy, confirmed by UDS. Using a traditional 8. ppm. +. cut-point for the early pregnancy reading, only 1% of non-smokers were incorrectly identified as smokers, but only 56% of all smokers, and 67% who smoked 5. + cigarettes in the previous 24. h, were identified. However, at 4. ppm. +, only 8% of non-smokers were misclassified as smokers, and 90% of all smokers and 96% who smoked 5. + cigarettes in the previous 24. h were identified. False positives were explained by heavy second hand smoke exposure and marijuana use. Results were similar for late pregnancy ECO, with ROC analysis revealing an area under the curve of 95 for early pregnancy, and 94 for late pregnancy readings. Conclusions: A lower 4. ppm ECO cut-point may be necessary to identify pregnant smokers using expired air samples, and this cut-point appears valid throughout pregnancy. Work is ongoing to validate findings in larger samples, but it appears if an appropriate cut-point is used, ECO is a valid method for determining smoking status in pregnancy.
机译：背景：测量呼出空气样品中的一氧化碳（ECO）是一种无创，经济高效的吸烟生化指标。切点为6. ppm-10。已经确定了ppm，尽管由于代谢变化，已经为孕妇确定适当的临界点。这项研究评估了是否可以建立一个ECO临界点，该临界点可以识别至少90％的孕妇吸烟者，而误识别少于10％的非吸烟者。方法：孕妇（N = 167）完成了一项经过验证的自我报告吸烟评估，对可替宁进行了尿液筛查（UDS），并在怀孕期间两次提供了过期的空气样本。结果：UDS证实，一半的女性在怀孕早期（51％）和晚期（53％）报告了不吸烟状态。使用传统的8. ppm。 +。怀孕初期的临界点，只有1％的非吸烟者被错误地识别为吸烟者，但在之前的24小时内，只有56％的吸烟者和67％的人吸烟了5。但是，为4. ppm。 +，只有8％的非吸烟者被错误地分类为吸烟者，并且在过去的24小时内，所有吸烟者中有90％的吸烟者和96％的人吸烟了5。大量二手烟和大麻的使用可以解释误报。妊娠晚期ECO的结果相似，ROC分析显示，妊娠早期曲线下面积为95，妊娠晚期读数为94。结论：使用过期的空气样本来识别怀孕的吸烟者可能需要降低4. ppm的ECO临界点，并且该临界点在整个怀孕期间都有效。正在进行工作以验证较大样本中的发现，但是如果使用了适当的临界点，ECO似乎是确定怀孕吸烟状况的有效方法。

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