Association between Serum Cotinine Levels, Fetal Biometry, and Umbilical Artery Flow in Pregnant Women Exposed to Secondhand Smoke

Margaret Diana; Deviana Soraya Riu; Fatmawati Madya; St. Maisuri T. Chalid; Nasrudin AM; Telly Tessy

doi:10.24198/obgynia.v8i3.956

Association between Serum Cotinine Levels, Fetal Biometry, and Umbilical Artery Flow in Pregnant Women Exposed to Secondhand Smoke

Margaret Diana, Deviana Soraya Riu, Fatmawati Madya, St. Maisuri T. Chalid, Nasrudin AM, Telly Tessy

Abstract

Objective: This study aimed to investigate the impact of SHS exposure on fetal biometry and umbilical artery flow at 24 – 28 weeks of gestation.
Methods: This cross-sectional study included 110 pregnant women, divided into a study group (55 passive) smokers and a control group (55 non-passive smokers). Serum cotinine levels were measured using ELISA. Fetal biometry (biparietal diameter, head circumference, abdominal circumference, and femur length) and umbilical artery flow (pulsatility and resistance indices) were assessed via ultrasound and Doppler ultrasonography. Group comparisons were conducted using Chi-square and independent t-tests.
Results: The passive smoker group had significantly higher mean serum cotinine levels compared with the control group (10.97 ng/mL vs. 4.53 ng/mL; p = 0.01). However, no statistically significant differences (p > 0.05) were found in any of the fetal biometric parameters or umbilical artery flow indices between the groups. Correlation analyses also showed no significant association between cotinine levels and the measured fetal outcomes.
Conclusion: In this second-trimester study, SHS exposure, confirmed by elevated cotinine levels, was not associated with measurable adverse effects on fetal biometry or umbilical artery flow. These non-significant findings underscore the need for longitudinal research to evaluate the cumulative impact of SHS, particularly in the third trimester and on final birth outcomes.

Hubungan antara Kadar Kotinin Serum, Biometri Janin, dan Aliran Arteri Umbilikalis pada Ibu Hamil yang Terpapar Asap Rokok Pasif

Abstrak
Tujuan: Penelitian ini bertujuan untuk menelaah dampak paparan asap rokok pasif terhadap biometri janin dan aliran arteri umbilikalis pada usia kehamilan 24 – 28 minggu.
Metode: Penelitian potong lintang ini melibatkan 110 ibu hamil yang dibagi menjadi kelompok studi (55 perokok pasif) dan kelompok kontrol (55 bukan perokok pasif). Kadar kotinin serum diukur menggunakan metode ELISA. Biometri janin (meliputi diameter biparietal, lingkar kepala, lingkar perut, dan panjang femur) serta aliran arteri umbilikalis (indeks pulsasi dan indeks resistensi) dinilai melalui ultrasonografi (USG) dan USG Doppler. Perbandingan antarkelompok dianalisis menggunakan uji Chi-square dan uji t independen.
Hasil: Kelompok perokok pasif memiliki rerata kadar kotinin serum yang secara signifikan lebih tinggi dibandingkan kelompok kontrol (10,97 ng/mL vs. 4,53 ng/mL; p = 0,01). Namun, tidak ditemukan perbedaan bermakna secara statistik (p > 0,05) pada parameter biometri janin maupun indeks aliran arteri umbilikalis antara kedua kelompok. Analisis korelasi juga tidak menunjukkan adanya hubungan bermakna antara kadar kotinin dengan luaran janin yang diukur.
Kesimpulan: Pada penelitian trimester kedua ini, paparan asap rokok pasif yang dikonfirmasi dengan peningkatan kadar kotinin tidak berhubungan dengan efek merugikan yang terdeteksi pada biometri janin maupun aliran arteri umbilikalis. Temuan yang tidak signifikan ini menekankan pentingnya penelitian longitudinal untuk menilai dampak kumulatif paparan asap rokok pasif, terutama pada trimester ketiga dan luaran kelahiran akhir.

Kata kunci: Aliran arteri umbilikalis; biometri janin; kotinin; paparan asap rokok pasif

Keywords

secondhand smoke exposure; cotinine; fetal biometry; umbilical arterial flow

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DOI: http://dx.doi.org/10.24198/obgynia.v8i3.956