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Prenatal Exposure to Nitrosatable Drugs, Vitamin C, and Risk of Selected Birth Defects
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8 2013
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Source: Birth Defects Res A Clin Mol Teratol. 97(8):515-531
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Details:
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Alternative Title:Birth Defects Res A Clin Mol Teratol
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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.
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Pubmed ID:23716465
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Pubmed Central ID:PMC5893146
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