ASPO Abstracts
Use of nitrosatable medications in pregnancy and the increased risks of pediatric cancers
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2023
Abstract Body:
Purpose: To explore whether intake of nitrosatable medications in pregnancy is related to increased risks of pediatric cancers. Methods: We conducted a cohort study of all children born in Taiwan from 2004-2015, linking the Cancer Registry, the Birth Registry, the Registry for Beneficiaries of the National Health Insurance Program, and the Pharmacy Database. The Pharmacy Database includes records and dates of all prescriptions filled in pharmacies in Taiwan. Nitrosatable drugs were identified via Anatomical Therapeutic Chemical (ATC) classification, and we examined overall intake and risk from medication subtypes (secondary amines, tertiary amines, amides). We used Cox proportional hazards modeling to quantify associations between childhood cancers and pregnancy intake of nitrosatable medications, with adjustment for maternal and paternal age, family income, urbanization of residence, and parental employment status. Results: The cohort included 2,079,037 children, of whom 2068 had been diagnosed with cancer. Overall, any pregnancy nitrosatable drug use was not substantially associated with cancer [all types combined; hazard ratio (HR)= 1.03, 95% confidence interval (CI) 0.94, 1.13] although tertiary amines were associated with cancer risk (HR=1.08, 95% CI 0.99, 1.18). For specific cancer types, we found that acute myeloid leukemia was related to maternal use of amides (HR=1.71, 95% CI 1.21, 2.41). Pregnancy intake of secondary amines was associated with an increased risk of hepatoblastoma (HR=1.40, 95% CI 0.87, 2.25). Weakly elevated risks were seen between pregnancy intake of secondary amines and retinoblastoma (HR=1.30, 95% CI 0.83, 2.03) and germ cell tumors and tertiary amines (HR=1.21, 95% CI 0.90, 1.63). Conclusion: Although the sample size was small, we observed elevated risk for specific cancer types with pregnancy intake of amides, tertiary amines, and secondary amines.
Keywords: Childhood cancer; pharmacoepidemiology; risk factors