Prenatal nitrate intake from drinking water and selected birth defects in offspring of participants in the national birth defects prevention study.

Abstract

BACKGROUND:

Previous studies of prenatal exposure to drinking-water nitrate and birth defects in offspring have not accounted for water consumption patterns or potential interaction with nitrosatable drugs.

OBJECTIVES:

We examined the relation between prenatal exposure to drinking-water nitrate and selected birth defects, accounting for maternal water consumption patterns and nitrosatable drug exposure.

METHODS:

With data from the National Birth Defects Prevention Study, we linked addresses of 3,300 case mothers and 1,121 control mothers from the Iowa and Texas sites to public water supplies and respective nitrate measurements. We assigned nitrate levels for bottled water from collection of representative samples and standard laboratory testing. Daily nitrate consumption was estimated from self-reported water consumption at home and work.

RESULTS:

With the lowest tertile of nitrate intake around conception as the referent group, mothers of babies with spina bifida were 2.0 times more likely (95% CI: 1.3, 3.2) to ingest ≥ 5 mg nitrate daily from drinking water (vs. < 0.91 mg) than control mothers. During 1 month preconception through the first trimester, mothers of limb deficiency, cleft palate, and cleft lip cases were, respectively, 1.8 (95% CI: 1.1, 3.1), 1.9 (95% CI: 1.2, 3.1), and 1.8 (95% CI: 1.1, 3.1) times more likely than control mothers to ingest ≥ 5.42 mg of nitrate daily (vs. < 1.0 mg). Higher water nitrate intake did not increase associations between prenatal nitrosatable drug use and birth defects.

CONCLUSIONS:

Higher water nitrate intake was associated with several birth defects in offspring, but did not strengthen associations between nitrosatable drugs and birth defects.

• Authors: Jean D Brender, Peter J Weyer, Paul A Romitti, Binayak P Mohanty, Mayura U Shinde, Ann M Vuong, Joseph R Sharkey, Dipankar Dwivedi, Scott A Horel, Jiji Kantamneni, John C Huber Jr, Qi Zheng, Martha M Werler, Katherine E Kelley, John S Griesenbeck, F Benjamin Zhan, Peter H Langlois, Lucina Suarez, Mark A Canfield, National Birth Defects Prevention Study
• Journal: Environmental health perspectives (Environ Health Perspect) Vol. 121 Issue 9 Pg. 1083-9 (Sep 2013) ISSN: 1552-9924 [Electronic] United States
• PMID: 23771435 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Drinking Water
• Nitrates

Topics

• Abnormalities, Drug-Induced (epidemiology, pathology)
• Cleft Lip (chemically induced)
• Cleft Palate (chemically induced)
• Cohort Studies
• Drinking Behavior
• Drinking Water (chemistry)
• Female
• Humans
• Limb Deformities, Congenital (chemically induced)
• Nitrates (analysis, toxicity)
• Pregnancy
• Prenatal Exposure Delayed Effects (chemically induced)
• Regression Analysis
• Spina Bifida Occulta (chemically induced)
• United States (epidemiology)