Birth‐related characteristics, congenital malformation, maternal reproductive history and neuroblastoma: The ESCALE study (SFCE)

Abstract

Since neuroblastoma occurs very early in children's lives, it has been hypothesized that pre-and perinatal factors may play a role in its etiology. This study investigated the role of birth characteristics, congenital malformation and maternal reproductive history in neuroblastoma. The data used were generated by the national population-based case-control study, ESCALE, conducted in France in [2003][2004]. The mothers of 191 neuroblastoma cases and 1,681 controls, frequency-matched by age and gender, were interviewed by telephone, using a standardized questionnaire, on several factors including pregnancy, medical history, lifestyle, childhood medical conditions and exposures. A positive association between congenital malformation and all neuroblastoma cases was observed [Odds ratio (OR) 5 2.2, 95% confidence interval (95% CI): 1.1-4.5]. Congenital malformations were highly associated to neuroblastoma in children aged less than 1 year (OR 5 16.8, 95% CI: 3.1-90), while no association was observed in children aged 1 year or more (OR 5 1.0, 95% CI: 0.3-2.9). A negative association with a maternal history of spontaneous abortions was also found (OR 5 0.6, 95% CI: 0.4-0.9). The results strongly support the hypothesis that congenital anomalies may be associated with neuroblastoma, particularly in infant (less than 1 year of age). ' 2007 Wiley-Liss, Inc.

Perinatal characteristics and risk of neuroblastoma

“…20 Maternal history of any fetal loss or miscarriage specifically has been positively associated with NB in some studies, 7,9,10,18,20 but not in others. 6,17,19,27 Results from our study are also inconsistent with a significant increased risk for a history of one, but not 2 fetal losses; the latter result could be due to low power to detect a significant association or to random variation.…”

“…17,[19][20][21]27,[38][39][40] The frequency of congenital abnormalities reported in the birth records of NB cases was not increased relative to that of controls in our study. However, the prevalence of congenital abnormalities recorded in birth records was only half that expected from national data that reports that 3% of infants are born with a major birth defect, 41 most likely due incomplete ascertainment and recording of birth defects on the birth certificate.…”

“…Three studies have reported increased risks for a prior history of induced abortions, 6,18,27 while one study has reported a decreased risk for 2 or more prior therapeutic abortions. 20 Maternal history of any fetal loss or miscarriage specifically has been positively associated with NB in some studies, 7,9,10,18,20 but not in others.…”

“…Our study was also limited because we did not have information on NB stage or MYCN amplification to address whether risk factors vary by these characteristics as indicated by some studies. 9,27 Another limitation of our study is the lack of follow-up of subcohort members and on cases diagnosed prior to 1988 (the year of the MCSS inception). Missed subcohort diagnoses after 1988 would most likely have been due to out-migration because MCSS is estimated to capture over 99.9% of Minnesota cancer cases.…”

Genetic Factors Influencing the Risk and Clinical Outcome of Neuroblastoma

“…A particular hallmark of neuroblastoma is its clinical heterogeneity, where some patients experience spontaneous regression or differentiation of the tumor into benign ganglioneuroma, while others are affected by rapid and fatal tumor progression (Schwab et al, 2003). Although the disease is often diagnosed in the perinatal period, environmental or parental risk factors have not been identified consistently and the molecular basis of neuroblastoma development and progression is still poorly understood (Hamrick et al, 2001;Urayama et al, 2007;Munzer et al, 2008). Recent advances in genome-wide studies have proven to be a useful prognostic tool for identifying genetic alleles or regions that may be used as risk markers for neuroblastoma development.…”