Prenatal Exposure to Nitrosatable Drugs, Vitamin C, and Risk of Selected Birth Defects

Details

• Alternative Title:
  Birth Defects Res A Clin Mol Teratol
• Personal Author:
  Shinde, Mayura U. ; Vuong, Ann M. ; Brender, Jean D. ; Werler, Martha M. ; Kelley, Katherine E. ; Huber, John C. ; Sharkey, Joseph R. ; Zheng, Qi ; Suarez, Lucina ; Langlois, Peter H. ; Canfield, Mark A. ; Romitti, Paul A. ; Malik, Sadia
• Corporate Authors:
  The National Birth Defects Prevention Study
• Description:
  BACKGROUND
  
  Nitrosatable drugs, such as secondary or tertiary amines and amides react with nitrite in an acidic environment to form N-nitroso compounds, teratogens in animal models. Vitamin C is a known nitrosation inhibitor.
  
  METHODS
  
  Using data from the National Birth Defects Prevention Study, we assessed nitrosatable drug exposure and vitamin C intake during the first trimester among 11,606 case-mothers of infants with oral clefts, limb deficiencies (LDs), or congenital heart defects and 6807 control-mothers of infants without major birth defects during 1997–2005. Daily intake of vitamin C was estimated from maternal interviews that elicited information about supplement use and dietary intake.
  
  RESULTS
  
  With no reported use of nitrosatable drugs as the referent group, a lower odds ratio (OR) was observed for transverse LDs among births to mothers exposed to secondary amine drugs and daily vitamin C supplementation (adjusted odds ratio [aOR] 1.2, 95% confidence interval [CI] 0.83–1.8) compared with women taking these drugs and no supplementation (aOR 2.7, 95% CI 1.5–4.6). The OR for longitudinal LDs associated with secondary amine exposure was lower with daily dietary vitamin C intake ≥85 mg (aOR 1.2, 95% CI 0.68–2.0) compared with <85 mg (aOR 1.9, 95% CI 1.2–3.1). Daily vitamin C supplementation in combination with higher dietary vitamin C intake reduced associations between nitrosatable drug exposures and limb deficiencies and atrial septal defects not otherwise specified.
  
  CONCLUSION
  
  Prenatal dietary and vitamin C supplement intake may diminish the association between nitrosatable drug exposure during pregnancy and selected birth defects.
  
  
• Subjects:
  Ascorbic Acid Brain Case-Control Studies Cleft Lip Cleft Palate Dietary Supplements Female Heart Defects, Congenital Humans Limb Deformities, Congenital Maternal Exposure Nitrosation Nitroso Compounds Pregnancy

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• Keywords:
  Birth Defects Dietary Vitamin C Heart Defects Limb Deficiencies Nitrosatable Drug Oral Clefts Vitamin C
• Source:
  Birth Defects Res A Clin Mol Teratol. 97(8):515-531
• Pubmed ID:
  23716465
• Pubmed Central ID:
  PMC5893146
• Document Type:
  Journal Article
• Funding:
  U01DD000494/DD/NCBDD CDC HHSUnited States/ ; U01 DD000492/DD/NCBDD CDC HHSUnited States/ ; 3R01ES015634-03S1/ES/NIEHS NIH HHSUnited States/ ; 5R01ES015634/ES/NIEHS NIH HHSUnited States/ ; U01 DD000494/DD/NCBDD CDC HHSUnited States/ ; R01 ES015634/ES/NIEHS NIH HHSUnited States/ ; U01 DD001035/DD/NCBDD CDC HHSUnited States/
• Volume:
  97
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:30294b6a5566f5bcab2f8300602907ba912c931eb2342fe558d808b59762081b77ad8120d5eedabb65a8eb875b90cfce3823ae017646fe9f5d51d096cf5a9f4c
• Download URL:
  https://stacks.cdc.gov/view/cdc/53227/cdc_53227_DS1.pdf
• File Type:
  [PDF - 564.56 KB ]