title: Prenatal Exposure to Nitrosatable Drugs, Dietary Intake of Nitrites, and Preterm Birth.
abstract: Prenatal exposure to nitrosatable drugs, including secondary or tertiary amines, has been associated with preterm birth. Associations may be accentuated by higher intakes of dietary nitrites because of the increased formation of N-nitroso compounds. Using data from mothers of babies without major birth defects (controls) from the National Birth Defects Prevention Study, we examined the relationship between nitrosatable drug exposure in conjunction with dietary nitrite intake and preterm birth among 496 mothers of preterm infants and 5,398 mothers with full-term deliveries in 1997-2005. A protective association was observed with a high intake of plant nitrites (adjusted hazard ratio (AHR) = 0.72, 95% confidence interval (CI): 0.53, 0.97). Secondary amines in conjunction with high nitrite intake were associated with preterm birth during the first (AHR = 1.84, 95% CI: 1.14, 2.98), second (AHR = 1.89, 95% CI: 1.17, 3.07), and third (AHR = 2.00, 95% CI: 1.22, 3.29) trimesters. The adjusted hazard ratios for tertiary amine use in the third trimester by increasing tertiles of nitrite intake were 0.67 (95% CI: 0.35, 1.31), 1.25 (95% CI: 0.71, 2.19), and 2.02 (95% CI: 1.17, 3.49). Prenatal exposure to nitrosatable drugs, particularly secondary and tertiary amines, in conjunction with higher levels of dietary nitrite intake may increase the risk of preterm birth.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Vuong
authors.forename: Mayura U
authors.initials: MU
authors.lastname: Shinde
authors.forename: Jean D
authors.initials: JD
authors.lastname: Brender
authors.forename: Eva M
authors.initials: EM
authors.lastname: Shipp
authors.forename: John C
authors.initials: JC
authors.lastname: Huber
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Sharkey
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: McDonald
authors.forename: Martha M
authors.initials: MM
authors.lastname: Werler
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Kelley
authors.forename: John S
authors.initials: JS
authors.lastname: Griesenbeck
authors.forename: Peter H
authors.initials: PH
authors.lastname: Langlois
authors.forename: Mark A
authors.initials: MA
authors.lastname: Canfield
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D004032:Diet / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009573:Nitrites / Q000009:adverse effects*; D009603:Nitroso Compounds / Q000009:adverse effects*; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology* / Q000209:etiology; D011297:Prenatal Exposure Delayed Effects; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D009573:Nitrites; D009603:Nitroso Compounds
keywords: adverse pregnancy outcome; nitrate; nitrite; nitrosatable drug; preterm birth; preterm delivery