Dataset Information

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

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.

SUBMITTER: Reynolds CME

PROVIDER: S-EPMC6059262 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Publications

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

Reynolds Ciara Marie Edel CME Egan Brendan B Kennedy Rachel Ak RA O'Malley Eimer G EG Sheehan Sharon R SR Turner Michael J MJ

BMJ open 20180723 7

<h4>Objectives</h4>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.<h4>Design</h4>A prospective observational study.<h4>Setting</h4>A university obstetric hospital in an urban setting in Ireland.<h4>Participants</h4>Women (n=250) and their partners (n=54) were recruited at their fi ...[more]

PMID: 30037878

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Project description:Purpose: Previous studies identified the study cohort or outcome of carbon monoxide poisoning (COP) by using the relevant disease diagnosis codes in secondary databases, but the validity of diagnosis codes of COP is unclear in such secondary databases. This study aimed to evaluate the accuracy of case definitions for COP using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes in Taiwan's health insurance claims data. Methods: We selected a 10% simple random sample from an original cohort of patients newly undergoing carboxyhemoglobin (COHb) testing under any clinical diagnosis at four Chang Gung Memorial Hospitals in Taiwan during 2011-2020. Two clinical doctors independently ascertained the COP diagnosis by reviewing the medical records as the reference standard. We estimated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of various case definitions (e.g., ICD-9-CM code, ICD-10-CM code and the uses of hyperbaric oxygen therapy) in the claims data. Results: We randomly selected 557 cases from the original cohort of 5,571 cases newly receiving COHb test in the study hospitals. We found 90, 35, and 9 cases were true-positive, false-positive, and false-negative episodes of COP, respectively, among 278 cases with an ICD-9-CM code of 986. A further 111, 34, and 6 cases were true-positive, false-positive, and false-negative episodes of COP, respectively, among 279 cases with an ICD-10-CM code of T58. Using ICD-9-CM codes, the sensitivity, specificity, PPV and NPV for COP were 90.9, 80.4, 72, and 94.1%, respectively. Using ICD-10-CM codes they were 94.9, 79, 76.6, and 95.5%, respectively. PPV typically increased when COP was the primary diagnosis and could reach 100% if patients with ICD-CM code 986 or T58 also received hyperbaric oxygen therapy during hospitalization. Conclusion: The COP-related ICD-CM codes alone did not accurately identify COP patients, but accuracy improved after including oxygen therapy data with the ICD-CM codes in Taiwan's claims data.

Dataset Information

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

Objectives

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

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

Similar Datasets

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