ClinicalTrials.gg
CompletedNCT02610751Updated Aug 28, 2019

Maternal Smoking During Pregnancy and Female Fetal Testosterone Levels

An observational study in Smoking, sponsored by TriHealth Inc.. Completed at 2 sites in United States. Open to female participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2019-08-28.

Sponsored by TriHealth Inc. · Observational

Study type
Observational
Model
Case-control
Time perspective
Prospective
Enrollment
80
Ages
18 Years and older
Sex
Female
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Study summary

  • The investigators hope their study will answer the question of whether or not fetal testosterone levels are increased in female newborns exposed to nicotine as a result of maternal smoking during pregnancy. Secondarily they plan to also evaluate maternal cotinine and testosterone levels and newborn anogenital distance, second digit to fourth digit (2D:4D) finger length ratio, newborn length and birth weight.
  • The investigators hope by performing this study, they will help to uncover the effect of tobacco exposure in utero on human female fetal testosterone levels, thus improving the counseling for tobacco use in pregnancy.
Read the detailed description

Epidemiological studies and laboratory research performed on animal models have revealed that the effects of maternal smoking during pregnancy go beyond the perinatal period due to the effect of nicotine on increasing fetal testosterone levels. This is of great concern as an increase fetal testosterone has been linked to impaired reproductive development and infertility in both male and female offspring, early onset of menarche in females, shorter body height, increased BMI, shortened anogenital distance and low second digit to fourth digit finger length ratio. Additionally elevated fetal testosterone levels have been associated with development of psychosocial disorders such as Autism, ADHD, antisocial behavior, conduct disorder, adult criminal behavior, and sensation seeking behavior.

Although there have been a few animal studies that have investigated the effects of maternal nicotine exposure on fetal testosterone levels with review of the epidemiologic literature on subsequent adverse implications, no known human studies have been performed to further investigate the relationship between maternal smoking during pregnancy and female fetal testosterone levels.

02

Conditions studied

  • Smoking

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Keywords

  • Maternal Smoking
  • Female Fetal Testosterone
  • Anogenital Distance
  • Maternal Testosterone
  • Maternal Cotinine
03

In context

Smoking

325 studies on the registry are indexed under Smoking; 141 are open to participants now.

This study's enrollment of 80 is below the median of 114 across 69 observational studies indexed under Smoking.

Browse Smoking studies →

Lead sponsor

TriHealth Inc. is the lead sponsor of 102 studies on the registry; 9 are open to participants now.

Of its 9 completed or terminated interventional studies of FDA-regulated products, 4 (44%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Smoking and non-smoking women greater than 18 years of age with a current singleton pregnancy with known female fetus confirmed by ultrasound.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Women, >/= 18 years old
  • Current singleton pregnancy
  • Recruited prior to 3rd trimester lab visit
  • Known female fetus confirmed by Ultrasound, typically performed 18 to 22 weeks, or later gestational age (GA)
  • Self reported smoker (of at least ½ pack per day) or non-smoker documented in electronic chart.
  • Eligibility will not be limited by desired mode of delivery

Exclusion criteria

Exclusion Criteria:

  • Patients who successfully quit smoking at \<14 weeks gestation and who have not resumed smoking during the pregnancy will be excluded from the case/control arm of study.
  • Patients considered light smokers, who self report smoking less than ½ pack per day.
  • Patients with Polycystic Ovarian Syndrome
05

Study design

Observational model
Case-control
Time perspective
Prospective
Enrollment
80 participants (actual)
Patient registry
No

Groups and cohorts

  • Smoking

    No interventions were applied to this group. Measurements of female fetal testosterone, maternal cotinine and testosterone levels, newborn anogenital distance, second digit to fourth digit (2D:4D) finger length ratio, newborn length and birth weight are collected.

  • Non-smoking

    No interventions were applied to this group. Measurements of female fetal testosterone, maternal cotinine and testosterone levels, newborn anogenital distance, second digit to fourth digit (2D:4D) finger length ratio, newborn length and birth weight are collected.

06

What researchers measure

Primary outcomes

  1. Female Fetal Testosterone level

    Time frame: At delivery

07

Study locations

2 sites
  • Good Samaritan Hospital
    Cincinnati, Ohio 45220, United States
  • Bethesda North Hospital
    Cincinnati, Ohio 45242, United States
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References and documents

Publications

  • Smith LM, Cloak CC, Poland RE, Torday J, Ross MG. Prenatal nicotine increases testosterone levels in the fetus and female offspring. Nicotine Tob Res. 2003 Jun;5(3):369-74. doi: 10.1080/146222031000094196. PubMed 12791533 ↗
  • Centers for Disease Control and Prevention (US); National Center for Chronic Disease Prevention and Health Promotion (US); Office on Smoking and Health (US). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2010. Available from http://www.ncbi.nlm.nih.gov/books/NBK53017/ PubMed 21452462 ↗
  • Duskova M, Hruskovicova H, Simunkova K, Starka L, Parizek A. The effects of smoking on steroid metabolism and fetal programming. J Steroid Biochem Mol Biol. 2014 Jan;139:138-43. doi: 10.1016/j.jsbmb.2013.05.003. Epub 2013 May 14. PubMed 23685014 ↗
  • Cornelius MD, Day NL. Developmental consequences of prenatal tobacco exposure. Curr Opin Neurol. 2009 Apr;22(2):121-5. doi: 10.1097/WCO.0b013e328326f6dc. PubMed 19532034 ↗
  • Cornelius MD, Leech SL, Goldschmidt L, Day NL. Is prenatal tobacco exposure a risk factor for early adolescent smoking? A follow-up study. Neurotoxicol Teratol. 2005 Jul-Aug;27(4):667-76. doi: 10.1016/j.ntt.2005.05.006. PubMed 16014324 ↗
  • Day NL, Richardson GA, Goldschmidt L, Cornelius MD. Effects of prenatal tobacco exposure on preschoolers' behavior. J Dev Behav Pediatr. 2000 Jun;21(3):180-8. PubMed 10883878 ↗
  • Ernst A, Kristensen SL, Toft G, Thulstrup AM, Hakonsen LB, Olsen SF, Ramlau-Hansen CH. Maternal smoking during pregnancy and reproductive health of daughters: a follow-up study spanning two decades. Hum Reprod. 2012 Dec;27(12):3593-600. doi: 10.1093/humrep/des337. Epub 2012 Oct 2. PubMed 23034153 ↗
  • Barbieri RL, York CM, Cherry ML, Ryan KJ. The effects of nicotine, cotinine and anabasine on rat adrenal 11 beta-hydroxylase and 21-hydroxylase. J Steroid Biochem. 1987 Jul;28(1):25-8. doi: 10.1016/0022-4731(87)90119-1. PubMed 3497305 ↗
  • Matta SG, Valentine JD, Sharp BM. Nicotinic activation of CRH neurons in extrahypothalamic regions of the rat brain. Endocrine. 1997 Oct;7(2):245-53. doi: 10.1007/BF02778147. PubMed 9549051 ↗
  • Stroud LR, Papandonatos GD, Shenassa E, Rodriguez D, Niaura R, LeWinn KZ, Lipsitt LP, Buka SL. Prenatal glucocorticoids and maternal smoking during pregnancy independently program adult nicotine dependence in daughters: a 40-year prospective study. Biol Psychiatry. 2014 Jan 1;75(1):47-55. doi: 10.1016/j.biopsych.2013.07.024. Epub 2013 Sep 10. PubMed 24034414 ↗
  • Benowitz NL. Cotinine as a biomarker of environmental tobacco smoke exposure. Epidemiol Rev. 1996;18(2):188-204. doi: 10.1093/oxfordjournals.epirev.a017925. No abstract available. PubMed 9021312 ↗
  • Benowitz NL, Jacob P 3rd, Fong I, Gupta S. Nicotine metabolic profile in man: comparison of cigarette smoking and transdermal nicotine. J Pharmacol Exp Ther. 1994 Jan;268(1):296-303. PubMed 8301571 ↗
  • James WH. Potential explanation of the reported association between maternal smoking and autism. Environ Health Perspect. 2013 Feb;121(2):a42. doi: 10.1289/ehp.1206268. No abstract available. PubMed 23380543 ↗
  • Fowler PA, Bhattacharya S, Flannigan S, Drake AJ, O'Shaughnessy PJ. Maternal cigarette smoking and effects on androgen action in male offspring: unexpected effects on second-trimester anogenital distance. J Clin Endocrinol Metab. 2011 Sep;96(9):E1502-6. doi: 10.1210/jc.2011-1100. Epub 2011 Jul 13. PubMed 21752894 ↗
  • Thankamony A, Ong KK, Dunger DB, Acerini CL, Hughes IA. Anogenital distance from birth to 2 years: a population study. Environ Health Perspect. 2009 Nov;117(11):1786-90. doi: 10.1289/ehp.0900881. Epub 2009 Jul 13. PubMed 20049133 ↗
  • Ravnborg TL, Jensen TK, Andersson AM, Toppari J, Skakkebaek NE, Jorgensen N. Prenatal and adult exposures to smoking are associated with adverse effects on reproductive hormones, semen quality, final height and body mass index. Hum Reprod. 2011 May;26(5):1000-11. doi: 10.1093/humrep/der011. Epub 2011 Feb 18. PubMed 21335416 ↗
  • Rizwan S, Manning JT, Brabin BJ. Maternal smoking during pregnancy and possible effects of in utero testosterone: evidence from the 2D:4D finger length ratio. Early Hum Dev. 2007 Feb;83(2):87-90. doi: 10.1016/j.earlhumdev.2006.05.005. Epub 2006 Jun 30. PubMed 16814493 ↗
  • James WH. An update on the hypothesis that one cause of autism is high intrauterine levels of testosterone of maternal origin. J Theor Biol. 2014 Aug 21;355:33-9. doi: 10.1016/j.jtbi.2014.03.036. Epub 2014 Apr 1. PubMed 24703983 ↗
  • Kandel DB, Udry JR. Prenatal effects of maternal smoking on daughters' smoking: nicotine or testosterone exposure? Am J Public Health. 1999 Sep;89(9):1377-83. doi: 10.2105/ajph.89.9.1377. PubMed 10474556 ↗
  • Cornelius MD, Leech SL, Goldschmidt L, Day NL. Prenatal tobacco exposure: is it a risk factor for early tobacco experimentation? Nicotine Tob Res. 2000 Feb;2(1):45-52. doi: 10.1080/14622200050011295. PubMed 11072440 ↗
  • Gordon SS, Dhanraj DN, Ganga Devaiah C, Lambers DS. A Pilot Study of Exposure to Nicotine in Human Pregnancy and Maternal and Fetal Testosterone Levels at Birth. Reprod Sci. 2022 Nov;29(11):3254-3259. doi: 10.1007/s43032-022-00967-2. Epub 2022 Jun 6. PubMed 35668167 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
Not marked actual or estimatedDates not marked actual or estimated

The record gives a start of Jan 2016, a primary completion of Aug 2019 and a completion of Aug 2019. It does not say whether these dates are actual or estimated.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 28, 2015
First posted
Nov 20, 2015
Start
Jan 2016
Primary completionActual
Aug 26, 2019
CompletionActual
Aug 26, 2019
Last update
Aug 28, 2019
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 28, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02610751
Lead sponsor
TriHealth Inc.
Responsible party
Sponsor
First posted
Nov 20, 2015
Start date
Jan 2016
Primary completion
Aug 26, 2019
Completion
Aug 26, 2019
Last update
Aug 28, 2019

Study contacts

Dave Dhanraj, MD, MBA
principal investigator · TriHealth Inc.

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Aug 2019. You cannot join it, but the record below documents what was studied.

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