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Chi-square and\n                      <jats:italic>t<\/jats:italic>\n                      -tests were used to compare sociodemographic factors of those who did and did not self-report tobacco use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean (SD) maternal age was 29.5 years (5.0); 85.2% had public insurance, and 92 (51.4%) took opioids prenatally. Ninety-five (53.1%) mothers self-reported prenatal tobacco product and\/or e-cigarette use, with cord cotinine detected in 98.9%. Of the 84 reporting no use, cotinine detection was 34.5%, resulting in moderate agreement (Gwet\u2019s AC1\u2009=\u20090.68\u00a0(0.571, 0.788),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Of those reporting no use, 27 (32.9%) had cotinine detected (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Biochemically verified cotinine detection was much higher than maternal self-reports of prenatal tobacco use. Inquiring about household and community smoke exposure may help inform optimal care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41372-026-02902-8","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:09:05Z","timestamp":1791385745000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of prenatal self-report of tobacco use to direct measurement of umbilical cord cotinine"],"prefix":"10.1038","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3893-885X","authenticated-orcid":false,"given":"E. 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This work was also supported, in part, by the National Institute of Environmental Health Sciences under award number R01ES030743.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"This study was approved by the institutional review board (IRB) of Cincinnati Children\u2019s Hospital Medical Center under IRB #2019-1161 and the other site IRBs approved the study via an established reliance agreement. Mothers\/legal guardians signed written informed consent for their infants to participate. This study was performed in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Ethics"}}]}}