Evidence map›Paper›PMID 41520413›Full record

ArticleInternational journal of hygiene and environmental health2026

Urinary cotinine cut-offs for tobacco smoke exposure in pregnancy and associations with child intelligence quotient: A multi-cohort analysis.

Yu Ni, Logan C Dearborn, Adam A Szpiro, Christine T Loftus, Qi Zhao, Nicole R Bush, Kaja Z LeWinn, Marnie F Hazlehurst, Thomas F Northrup, Penelope J E Quintana and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of hygiene and environmental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Yu NiDivision of Epidemiology and Biostatistics, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, CA, USA. Electronic address: yni5@sdsu.edu.
Logan C DearbornDepartment of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
Adam A SzpiroDepartment of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA.
Christine T LoftusDepartment of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
Qi ZhaoDepartment of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
Nicole R BushDepartment of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Kaja Z LeWinnDepartment of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Marnie F HazlehurstSeattle Children's Research Institute, Seattle, WA, USA.
Thomas F NorthrupDepartment of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
Penelope J E QuintanaDivision of Environmental Health, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, CA, USA.
Eunha HohDivision of Environmental Health, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, CA, USA.
Georg MattDepartment of Psychology, College of Science, San Diego State University, San Diego, CA, USA.
Catherine J KarrDepartment of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA.

Funding

XENOBIOTIC BIOTRANSFORMATION AND DISPOSITIONP30ES007033 · NIEHS · UNIVERSITY OF WASHINGTON · PI Nicole Ann Errett · 1995 to 2026
$42.5M
Prenatal and Early Childhood Pathways To Health:  An Integrated Model of Chemical and Social Exposures, Biological Mechanisms, and Sex-Specific Effects on Neurodevelopment and Respiratory OutcomesUH3OD023271 · OD · UNIVERSITY OF WASHINGTON · PI BUSH, NICOLE RENEE, KARR, CATHERINE J · 2018 to 2022
$37.3M
TIDES III: Endocrine Disruption, Hormones, and Sex Differences in Adolescent Airway HealthR01ES025169 · NIEHS · SEATTLE CHILDREN'S HOSPITAL · PI Sheela Sathyanarayana · 2015 to 2026
$9.5M
Prenatal and Early Childhood Pathways To Health:  An Integrated Model of Chemical and Social Exposures, Biological Mechanisms, and Sex-Specific Effects on Neurodevelopment and Respiratory OutcomesUG3OD023271 · OD · UNIVERSITY OF WASHINGTON · PI BUSH, NICOLE RENEE, KARR, CATHERINE J · 2016 to 2017
$5.1M
The Infant Development and the Environmental Study (TIDES)R01ES016863 · NIEHS · UNIVERSITY OF ROCHESTER · PI SWAN, SHANNA H · 2009 to 2014
$4.0M
Pregnancy Folate Status & Early Childhood Respiratory & Atopic Disease OutcomesR01HL109977 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI CARROLL, KECIA NICOLE · 2011 to 2015
$3.4M
NHLBI NIH HHS R01 HL109977NIEHS NIH HHS P30 ES007033NIEHS NIH HHS R01 ES016863NIEHS NIH HHS R01 ES025169NIH HHS UG3 OD023271NIH HHS UH3 OD023271
6 · The paper itself

Abstract

backgroundPrenatal exposure to tobacco smoke may impair neurodevelopment in children. However, accurately characterizing this exposure remains challenging.

methodsWe pursued two objectives in this large population study. First, in 1708 pregnant women from the Environmental Influences on Child Health Outcomes (ECHO) cohort, we constructed Receiver Operating Characteristic (ROC) curves to determine urinary cotinine cut-offs to classify firsthand (FHS), environmental (ETS), and no exposure, and further distinguished secondhand (SHS) from thirdhand smoke (THS) exposure within ETS. Second, among 1593 participants in three pregnancy cohorts nested in ECHO, we fit multivariable linear regressions to examine the association between the newly defined smoke exposures and child full-scale intelligence quotient (IQ) at age 4-6 years, and to assess potential effect modification by maternal education or neighborhood deprivation.

resultsOptimal cotinine cut-offs were 17.74 ng/mL and 0.44 ng/mL to discriminate FHS and no exposure, respectively. Among the ETS group, a cut-off of 5.69 ng/mL differentiated SHS from THS. Applying these optimal cut-offs, we estimated a 0.93-point (95 %CI: 3.44, 1.59) and a 1.03-point (95 %CI: 2.84, 0.79) lower child IQ in the FHS and ETS categories, respectively, compared to no exposure. The inverse association between prenatal ETS and child IQ was mainly driven by SHS. Stronger associations were suggested in subgroups with higher education attainment or those living in less deprived neighborhoods.

conclusionsThis study provides a novel classification of prenatal tobacco smoke exposures. Although the associations with child IQ were statistically insignificant, the study carries important implications for future research on developmental origins of diseases.

Indexed as

CotinineIntelligenceMaternal ExposurePrenatal Exposure Delayed EffectsTobacco Smoke PollutionAdultChildChild, PreschoolCohort StudiesFemaleHumansIntelligence TestsMalePregnancyCotinineTobacco Smoke PollutionChild cognitive functionEnvironmental smoke exposureMaternal smokingOptimal cut-offsSecondhand smoke exposureThirdhand smoke exposureUrinary cotinine

Identifiers

PMID41520413
PMCPMC12995295

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.