This study investigated the relation between fetal exposure to cigarette smoke at the end of pregnancy, through measuring cotinine in cord serum and compare it with the quantitative measurement of smoking intake and exposure evaluated by maternal self-reported questionnaire. A cross sectional study was conducted in Al Elwyea Maternity Teaching hospital in Baghdad city. Mothers and their newly born babies were included in the study during a period from August till November 2008 . A Sample of 88 mothers and their newly born babies were selected through convenient sampling technique taken from pregnant women attending the hospital for delivery in the delivery room of Al Elwyea hospital and interview was done with the mothers before and after delivery to complete the questionnaire. Its attempt to assess the effect of different epidemiological factors on fetus during exposure to environmental tobacco smoke like parents age , residence, education state , newborn sex , order in the family , baby’s APGAR score , weight , length , head circumference , Anti Natal care (ANC) of the mother ,gestational age , placenta problem, and parents BMI .
Result shows that 11.4% had placenta privea, and 3.4% had placenta abrobtion among studied mothers in the current pregnancy,also the percentage of the mothers with a gestational age less that 37weeks was 60.2% ,regarding history of abortion it shows that 13.6% of the mother had abortion previously ,and 81.8% of mothers received antenatal care ANC in this pregnancy ,also shows that percentage of babies with low birthweight <2500 grams was 37.5% and 31.8% of babies whose length were <50 cm and head circumference groups <35 cm were 25%. Linear relationship was found in this study between nicotine estimated from questionnaire form and laboratory cotinine (biomarker of nicotine) levels in babies cord blood with significant p value. The laboratory cotinine level from cord blood of the mother was much higher than nicotine level from questionnaire. Relation between cotinine and its impact on growth was significant as the relation between mean values of laboratory cotinine level in the cord blood and babies birth weight, gestational age, APGAR score (at first minute). Finally, this study put forward recommendations hopfully that the future studies and legislations will help in improvement of future health by preventing the exposure of the fetus to environmental tobacco smoke .