Prevalence and Patterns of Nitrosatable Drug Use among U.S. Women during Early Pregnancy

Jean D Brender; Katherine E Kelley; Martha M Werler; Peter H Langlois; Lucina Suarez; Mark A Canfield; National Birth Defects Prevention Study

doi:10.1002/bdra.20808

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Prevalence and Patterns of Nitrosatable Drug Use among U.S. Women during Early Pregnancy

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Prevalence and Patterns of Nitrosatable Drug Use among U.S. Women during Early Pregnancy

Jean D Brender, Katherine E Kelley, Martha M Werler, Peter H Langlois, Lucina Suarez, Mark A Canfield and National Birth Defects Prevention Study

Birth defects research. A Clinical and molecular teratology, Vol.91(4), pp.258-264

04/2011

DOI: 10.1002/bdra.20808

PMCID: PMC3107676

PMID: 21472845

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Abstract

BACKROUND Experimental evidence indicates that certain drugs, that are secondary or tertiary amines or amides, form N-nitroso compounds in the presence of nitrite in an acidic environment. Nitrosatable drugs have been associated with birth defects in a few epidemiologic studies. This study describes the prevalence and patterns of nitrosatable drug use among U.S. women during early pregnancy and examines maternal factors associated with such use. METHODS Data were analyzed from the National Birth Defects Prevention Study and included 6807 mothers who gave birth to babies without major congenital malformations during 1997 to 2005. Information was collected by telephone interview about medication use, demographic factors, and maternal health. Drugs taken during the first trimester were classified according to nitrosatability, amine and amide functional groups, and primary indication of use. RESULTS Approximately 24% of the women took one or more nitrosatable drugs during the first trimester, including 12.4%, 12.2%, and 7.6% who respectively took secondary amines, tertiary amines, or amides. Five of the ten most commonly taken drugs were available over the counter. Women who were non-Hispanic white (29.5%), with 1 year or more college education (27.3%) or 40 years or older (28.8%) had the highest prevalence of use. Supplemental vitamin C, an inhibitor of nitrosation, was not taken by 41.6% and 19.3% of nitrosatable drug users during the first and second months of pregnancy, respectively. CONCLUSIONS In this U.S. population, ingestion of drugs classified as nitrosatable was common during the first trimester of pregnancy, especially among non-Hispanic white, more educated, and older mothers.

nitrosatable drugs

nitrosation

Original

pregnancy, N-nitroso compounds

secondary amine

tertiary amine

Details

Title: Subtitle: Prevalence and Patterns of Nitrosatable Drug Use among U.S. Women during Early Pregnancy
Creators: Jean D Brender - Texas A&M Health Science Center, School of Rural Public Health, College Station
Katherine E Kelley - Slone Epidemiology Center at Boston University
Martha M Werler - Slone Epidemiology Center at Boston University
Peter H Langlois - Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services
Lucina Suarez - Environmental Epidemiology and Disease Registries, Texas Department of State Health Services
Mark A Canfield - Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services
National Birth Defects Prevention Study
Contributors: Paul A Romitti (Contributor) - University of Iowa, Epidemiology
Resource Type: Journal article
Publication Details: Birth defects research. A Clinical and molecular teratology, Vol.91(4), pp.258-264
DOI: 10.1002/bdra.20808
PMID: 21472845
PMCID: PMC3107676
NLM abbreviation: Birth Defects Res A Clin Mol Teratol
ISSN: 1542-0752
eISSN: 1542-0760
Publisher: Wiley
Language: English
Date published: 04/2011
Academic Unit: Epidemiology; Biostatistics
Record Identifier: 9984214952002771

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