[Determination of 4-(methylnirosamino) -4-(3-pyridyl)-1-butanol (NNA) in urine of pregnant women by means of LC/MS/MS].

An important problem, particularly from the point of view of the medicine, is active tobacco smoking and passive exposure to tobacco smoke of pregnant women and unfavourable health aftermath for the foetus and a newborns resulting from this. The aim of this study was to evaluate the exposure of smoking mothers to tobacco-specific N-nitrosamines, through the measurement of 4-(metylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in urine. The evaluation of tobacco smoking was performed on the basis of questionnaire studies and determination of cotinine in urine. The questionnaire studies that have been carried out, allowed the patients to be divided into two groups: women who do not smoke and are not exposed to ETS (17 women), and the ones who smoke (14 women). The women who smoked 11-15 cigarettes a day and more than 16 cigarettes constituted the largest percentage. The conformance of the declaration with the real exposure to tobacco smoke within the group of non-smoking women was 88%. Within the group of non-smoking women, the level of cotinine in 15 cases was 0 ng/ mg of creatinine, whereas in two cases, it amounted to 19.4 and 215.4 ng/mg of creatinine respectively. Among the persons, who were smoking, there were 4 cases, where the biomarker's level was 0 ng/mg of creatinine, and in 10 cases, the mean concentration of cotinine was 169.1 +/- 121.8 ng/mg of creatinine. The measurement of the content of tobacco-specific N-nitrosamines (NNAL- metabolite of NNK) in the urine of pregnant woman was carried out by means of the liquid chromatography/tandem mass spectrometry (LC/MS/MS). The analysis of obtained results showed that the mean concentration of NNAL in urine of smoking women was 59.2 +/- 40.2 pg/ ml. In the case of two patients, who declared to be non-smokers, and in the case of whom, the presence of cotinine was detected (19.4 and 215.4 ng/mg of and 88.4 pg/ml. The presence of 4-(metylnitrosamino)-1-(3-pyridyl)-1-butanol in the mother's urine, speaks volumes for the possible risk of exposure of a foetus to the cancerogenic components of tobacco smoke. The applied LC/MS/ MS method of determination of NNAL in urine, which allows the quantity of several pg/ml of the smoker's urine to be determined, can be used to mark the biomarker of exposure to the tobacco-specific N-nitrosamines. The lack of correlation between cotinine and NNAL concentration in urine, and the number of smoked cigarettes, speaks volumes for the lapse of quite a long time from the moment of cigarette smoking to the moment of collection of the biological material for research and the possible incredible declaration as to the number of smoked cigarettes. Only a slight tendency for the increase in the concentration of NNAL as well as the increase in the cotinine level could be caused by the difference in pharmacokinetic parameters of marked metabolites at the moment of smoking cessation.