Abstract
Background
The etiopathogenesis of childhood cancer is poorly understood. As most cases present in the first years of life, many epidemiologists hypothesize that perinatal exposures have a role in its pathogenesis. Some researchers have found associations with maternal age, fetal growth, maternal anaemia, history of miscarriage, maternal overweight and smoking, yet others have found none. Research in this area has been limited by sample size and recall or reporting bias. Record linkage of a cancer registry with a birth register allows investigation of maternal and perinatal risk factors for childhood cancer implicated in the literature.
Aims
To investigate maternal and perinatal risk factors for childhood cancer, specifically effects of intrauterine growth restriction and preterm birth.
Methods
Case control analysis of linked records from the Aberdeen Maternity and Neonatal Databank with the Scottish Cancer Registry and the General Registry of Births and Deaths in Scotland was carried out. Cases (176) comprised children diagnosed with cancer under 15 years or recorded as having died of cancer. Four controls per case (704) were matched by age and gender. Maternal sociodemographic factors such as age, BMI, social class, marital status and smoking were compared between cases and controls. Preeclampsia, antepartum haemorrhage and previous miscarriage as well as gestational age, birthweight, and Apgar scores were compared between groups to test for association with cancer. Adjusted odds ratios with 95% confidence intervals were calculated using conditional logistic regression.
Results
Of the 86 cases for which there were data on the site of the cancer, 22 (25.6%) were acute lymphoblastic leukaemia, 15 (17.4%) were malignant neoplasms of the brain, and 6 (7.0%) were malignant neoplasms of the kidney. Of the maternal characteristics tested, mother’s age at delivery (cases mean = 28.9, s.d. = 5.6; controls mean = 30.2, s.d. = 4.6; p = 0.002) and smoking status (38.6% current or ex-smokers among cases, 29.7% among controls) were found to be significantly different between groups. Of the perinatal factors tested, preterm birth (adjusted odds ratio 2.21, 95% CI 1.28, 3.82), low birthweight (OR 1.83, 95% CI 1.00, 3.35), low Apgar score at 5 minutes (OR 5.29, 95% CI 1.79, 15.66) and delivery by caesarean section (OR 2.07, 95% CI 1.41, 3.04) showed statistically significant association with childhood cancer.
Conclusions
Some associations found between childhood cancer and maternal characteristics and perinatal factors in this study are replications of previous research, however previously found associations with BMI, previous miscarriage and intrauterine growth restriction were not suggested here. The association observed between caesarean delivery and childhood cancer has not been reported before.
The etiopathogenesis of childhood cancer is poorly understood. As most cases present in the first years of life, many epidemiologists hypothesize that perinatal exposures have a role in its pathogenesis. Some researchers have found associations with maternal age, fetal growth, maternal anaemia, history of miscarriage, maternal overweight and smoking, yet others have found none. Research in this area has been limited by sample size and recall or reporting bias. Record linkage of a cancer registry with a birth register allows investigation of maternal and perinatal risk factors for childhood cancer implicated in the literature.
Aims
To investigate maternal and perinatal risk factors for childhood cancer, specifically effects of intrauterine growth restriction and preterm birth.
Methods
Case control analysis of linked records from the Aberdeen Maternity and Neonatal Databank with the Scottish Cancer Registry and the General Registry of Births and Deaths in Scotland was carried out. Cases (176) comprised children diagnosed with cancer under 15 years or recorded as having died of cancer. Four controls per case (704) were matched by age and gender. Maternal sociodemographic factors such as age, BMI, social class, marital status and smoking were compared between cases and controls. Preeclampsia, antepartum haemorrhage and previous miscarriage as well as gestational age, birthweight, and Apgar scores were compared between groups to test for association with cancer. Adjusted odds ratios with 95% confidence intervals were calculated using conditional logistic regression.
Results
Of the 86 cases for which there were data on the site of the cancer, 22 (25.6%) were acute lymphoblastic leukaemia, 15 (17.4%) were malignant neoplasms of the brain, and 6 (7.0%) were malignant neoplasms of the kidney. Of the maternal characteristics tested, mother’s age at delivery (cases mean = 28.9, s.d. = 5.6; controls mean = 30.2, s.d. = 4.6; p = 0.002) and smoking status (38.6% current or ex-smokers among cases, 29.7% among controls) were found to be significantly different between groups. Of the perinatal factors tested, preterm birth (adjusted odds ratio 2.21, 95% CI 1.28, 3.82), low birthweight (OR 1.83, 95% CI 1.00, 3.35), low Apgar score at 5 minutes (OR 5.29, 95% CI 1.79, 15.66) and delivery by caesarean section (OR 2.07, 95% CI 1.41, 3.04) showed statistically significant association with childhood cancer.
Conclusions
Some associations found between childhood cancer and maternal characteristics and perinatal factors in this study are replications of previous research, however previously found associations with BMI, previous miscarriage and intrauterine growth restriction were not suggested here. The association observed between caesarean delivery and childhood cancer has not been reported before.
| Original language | English |
|---|---|
| Publication status | Published - Sept 2011 |
| Event | Society for Social Medicine 55th Annual Scientific Meeting - University of Warwick, Warwick, United Kingdom Duration: 14 Sept 2011 → 16 Sept 2011 |
Conference
| Conference | Society for Social Medicine 55th Annual Scientific Meeting |
|---|---|
| Country/Territory | United Kingdom |
| City | Warwick |
| Period | 14/09/11 → 16/09/11 |
Keywords
- childhood cancer
- epidemiology
