Evidence map›Paper›PMID 36300575›Full record

ArticlePharmacoepidemiology and drug safety2023

Exposure to nitrosatable drugs during pregnancy and childhood cancer: A matched case-control study in Denmark, 1996-2016.

Anupong Sirirungreung, Johnni Hansen, Di He, Xiwen Huang, Beate Ritz, Julia E Heck

Abstract read
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In one paragraph

Article in Pharmacoepidemiology and drug safety, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Exposure to Acetaminophen (Paracetamol) during Pregnancy and Childhood Cancer: A Population-Based Cohort Study in Taiwan.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026
    Article
  4. Temporal clustering of neuroblastic tumours in children and young adults from Scotland.Environmental health : a global access science source · 2026
    Article
  5. Review
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Anupong SirirungreungDepartment of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA.ORCID 0000-0003-2571-2680
Johnni HansenDanish Cancer Society Research Center, Copenhagen, Denmark.
Di HeDepartment of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA.
Xiwen HuangDepartment of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA.
Beate RitzDepartment of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA.
Julia E HeckDepartment of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA.

Funding

Maternal comorbidities, prescription drug use in pregnancy and childhood cancerR21CA175959 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI HECK, JULIA · 2014 to 2015
$323k
Parental Occupation and Childhood CancersR03ES021643 · NIEHS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI HECK, JULIA · 2012 to 2013
$152k
NCI NIH HHS R21 CA175959NIEHS NIH HHS R03 ES021643
6 · The paper itself

Abstract

backgroundNitrosatable drugs can be synthesized to N-nitroso compounds in human stomach. In a pregnant woman, N-nitroso compounds can be translocated to the fetus through the placenta. Maternal exposure of nitrosatable compounds during pregnancy has been associated with childhood brain tumors and leukemia. However, few studies have investigated an association between nitrosatable drug exposure during pregnancy and childhood cancer. We examined if maternal prescriptions of nitrosatable drugs received during pregnancy are associated with childhood cancer.

methodsA matched case-control study was conducted using Danish nationwide registry data from 1995 to 2016. Each childhood cancer case was matched with twenty-five controls. Maternal exposure of nitrosatable drugs during pregnancy was identified from the Danish National Prescription Register. A multivariable conditional logistic regression model was used to estimate adjusted odds ratios (adj.OR) with 95% confidence intervals (CI) for each childhood cancer type.

resultsMaternal prescriptions of nitrosatable drugs positively associate with central nervous system tumors (adj.OR = 1.25; 95% CI = 1.04-1.51) and neuroblastoma (adj.OR = 1.96; 95% CI = 1.34-2.85) in offspring. We also observed a positive association between perinatal exposure of nitrosatable drugs and acute lymphoblastic leukemia (adj.OR = 1.31; 95% CI = 1.07-1.59), however, it appeared to be due to confounding by indication, i.e., maternal infections.

conclusionNitrosatable drug use during pregnancy potentially increased risk of central nervous system tumors and neuroblastoma. While a positive association between maternal prescriptions of nitrosatable drugs and acute lymphoblastic leukemia should be interpreted cautiously because of confounding by indication.

Indexed as

Central Nervous System NeoplasmsNeuroblastomaPrecursor Cell Lymphoblastic Leukemia-LymphomaPrenatal Exposure Delayed EffectsCase-Control StudiesChildDenmarkFemaleHumansNitroso CompoundsPregnancyRisk FactorsNitroso Compoundschildhood cancerDenmarknitrosatable drugN-nitroso compoundpregnancy

Identifiers

PMID36300575
PMCPMC10038857

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.