Background: Cigarette smoking during pregnancy can result in fetal exposure
to carcinogens that are transferred from the mother via the placenta, but
little information is available on fetal uptake of such compounds. We analy
zed samples of the first urine from newborns whose mothers did or did not s
moke cigarettes for the presence of metabolites of the potent tobacco-speci
fic transplacental carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanon
e (NNK), Methods: The urine was collected and analyzed for two metabolites
of NNK, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and its glucur
onide (NNAL-Gluc). Gas chromatography and nitrosamine-selective detection,
with confirmation by mass spectrometry, were used in the analyses, which we
re performed without knowledge of the origin of the urine samples. Results:
NNAL-Gluc was detected in 22 (71%) of 31 urine samples from newborns of mo
thers who smoked; NNAL was detected in four of these 31 urine samples, Neit
her compound was detected in the 17 urine samples from newborns of mothers
who did not smoke. The arithmetic mean level of NNAL plus NNAL-Gluc in the
27 newborns of smokers for which both analytes were quantified was 0.14 (95
% confidence interval [CI] = 0.083-0.200) pmol/mL, The levels of NNAL plus
NNAL-Gluc in the urine from these babies were statistically significantly h
igher than those in the urine from newborns of nonsmoking mothers (geometri
c means = 0.062 [95% CI = 0.035-0.110] and 0.010 [considered as not detecte
d; no confidence interval], respectively; two-sided P<.001). NNAL plus NNAL
-Gluc levels in the 18 positive urine samples in which both analytes were q
uantified ranged from 0.045 to 0.400 pmol/mL, with an arithmetic mean level
of 0.20 (95% CI = 0.14-0.26) pmol/mL, about 5%-10% of the levels of these
compounds detected in the urine from adult smokers. Conclusions: Two metabo
lites of the tobacco-specific transplacental carcinogen NNK can be detected
in the urine from newborns of mothers who smoked cigarettes during pregnan
cy.