Maternal Exposure to N-Nitrosatable Drugs as a Risk Factor for Childhood Brain Tumours

Abstract

Our findings suggest that no increased risk of childhood brain tumours was associated with maternal exposure to nitrosatable drugs. The study results should be viewed with caution given the imprecision of the point estimates as well as the lack of data on specific timing and dosage of exposure and degree of nitrosatability of drugs taken.

Medication use during pregnancy and the risk of childhood cancer in the offspring

“…One study on childhood brain tumors found an elevated odds ratio of 1.8 for astrocytoma [5], but this was not confirmed in the current study. However, the odds ratio for neuroblastoma was slightly elevated (odds ratio of 1.36), corresponding to a small risk excess observed in the largest neuroblastoma study to date (odds ratio 1.4, 95 percent CI: 1.0, 1.9) [7].…”

“…A possible mechanism for the association between diuretics and antihypertensives might be the toxic presence of n-nitroso precursors. N-nitroso is a strong transplancental nervous system carcinogen [25,39] and is known to be an ingredient in some diuretics, e.g., furosemide and hydrochlorothiazid and also antihypertensives such as propanolol [7]. It might also be that, in case of a cancer of the fetus, catecholamine production might be responsible for maternal hypertension followed by the accordant medication [39].…”

Childhood Brain Tumor Epidemiology: A Brain Tumor Epidemiology Consortium Review

“…Two studies prior to 2004 did not find statistical evidence for an association between maternal exposure to nitrosable drugs and offspring CBTs. (76, 77) Likewise, a large study published in 2006 that included 1,218 CBT cases and 1,218 controls found little support for an association between CBTs and medications containing amines or amides (OR=1.01; 95% CI 0.82–1.24) overall or for astroglial (OR=1.01; 95% CI 0.78–1.31), PNET (OR=1.09; 95% CI 0.75–1.60), or other glial (OR=1.01; 95% CI 0.71–1.44) subtypes. No significant associations were found when data were analyzed by age group (≤5 vs. >5 years) or class of drugs (barbituates, antiepileptics, antihistamines, neurally active drugs, diuretics, sex hormones, or antiemetics).…”

Maternal use of antibiotics and cancer in the offspring: results of a case–control study in Germany

“…A possible association between childhood cancer and maternal infections [7][8][9][10][11][12] and/or the maternal use of antibiotics [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] has been investigated in a number of case-control and cohort studies ( Table 1). The studies looked at different exposure periods between 3 months prior to conception and the first month of breastfeeding.…”

“…The studies looked at different exposure periods between 3 months prior to conception and the first month of breastfeeding. In summary, the majority of studies did not show a clear evidence for an association between cancer in the offspring and maternal use of antibiotics, as risk estimates were not or only marginally increased [13][14][15][16][17][18][19][20]. Four studies observed increased relative risks but the increase was not statistically significant [21][22][23][24].…”