Birth weight and other perinatal characteristics and childhood leukemia in California

Abstract

Aims We conducted a large registry-based study in California to investigate the association of perinatal factors and childhood leukemia with analysis of two major subtypes, acute lymphocytic leukemia (ALL) and acute myeloid leukemia (AML). Methods We linked California cancer and birth registries to obtain information on 5788 cases and 5788 controls matched on age and sex (1:1). We examined the association of birth weight, gestational age, birth and pregnancy order, parental ages, and specific conditions during pregnancy and risk of total leukemia, ALL and AML using conditional logistic regression, with adjustment for potential confounders. Results The odds ratio (OR) per 1000 gram increase in birth weight was 1.11 for both total leukemia and ALL. The OR were highest for babies weighing ≥4,500g with reference <2,500g: 1.59 (95% CI: 1.05-2.40) and 1.70 (95% CI: 1.08-2.68) for total leukemia and ALL, respectively. For AML, increase in risk was also observed but the estimate was imprecise due to small numbers. Compared to average-for-gestational age (AGA), large-for-gestational age (LGA) babies were at slightly increased risk of total childhood leukemia (OR=1.10) and both ALL and AML (OR=1.07 and OR=1.13, respectively) but estimates were imprecise. Being small-forgestational age (SGA) was associated with reduced risk of childhood leukemia (OR=0.81, 95% CI: 0.67-0.97) and ALL (OR=0.77, 95% CI: 0.63-0.94), but not AML. Being first-born was associated with decreased risk of AML only (OR=0.70; 95% CI: 0.53-0.93). Compared to children with paternal age <25 years, children with paternal age between 35 and 45 years were at increased risk of total childhood leukemia (OR=1.12; 95% CI: 1.04-1.40) and ALL (OR=1.23; 95% CI: 1.04-1.47). None of conditions during pregnancy examined or maternal age were associated with increased risk of childhood leukemia or its subtypes. Conclusions Our results suggest that high birth weight and LGA were associated with increased risk and SGA with decreased risk of total childhood leukemia and ALL, being first-born was associated with decreased risk of AML, and advanced paternal age was associated with increased risk of ALL. These findings suggest that associations of childhood leukemia and perinatal factors depend highly on subtype of leukemia.

The Sperm Epigenome, Male Aging, and Potential Effects on the Embryo

“…The fact that males are still fertile at advanced ages may present, and potentially complicate, another issue that, while subtle, is far more consistent, namely, the effect of paternal age on offspring health and disease susceptibility. It has been shown that the offspring of older fathers have increased incidence of various forms of cancer, including hematological and central nervous system tumors (Hemminki et al 1999 ;Oksuzyan et al 2012 ;Murray et al 2002 ;Yip et al 2006 ), though the data remains somewhat controversial. Furthermore, it has long been suggested that advanced paternal age is a risk factor for schizophrenia (Hare and Moran 1979 ;Miller et al 2011 ;Matheson et al 2011 ;Wohl and Gorwood 2007 ).…”

Preterm Birth and Subsequent Risk of Acute Childhood Leukemia: a Meta-Analysis of Observational Studies

“…3). Seven studies including 2,432,599 participants and 1,413 cases were selected in this meta-analysis of childhood AML [12][13][14][15][16][17]21]. The results suggested that preterm birth was …”

“…4). [12,15,16], higher in girl (none), or undefined [14]), children's age of leukemia diagnosis (AL:<5 years old [12,[15][16][17][18][19][20][21][22] or undefined [13,14,20,23,24] ;ALL:<5 years old [12,[15][16][17]21] or undefined [13,14,20]; AML:<5 years old [12,[15][16][17]21] or undefined [13,14]) and source of data for gestation age (AL: register or record [12-19, 23, 24] or digit dialing or questionnaire [1, 2, 4-7, 9-11, 13]; ALL: register or record [12][13][14][15][16][17] or digit dialing or questionnaire [20,21]; AML: register or record [12][13][14][15][16]…”

Birth order and risk of childhood cancer in the Danish birth cohort of 1973–2010

“…In a five-state register-based study in the USA with 4,699 ALL cases diagnosed between 1980 and 2004, odds ratios were nonsignificantly lower than one, namely 0.97, 0.96, and 0.94, for children born second, third, or fourth or higher, respectively, compared with firstborn children [4]. In a Californian register-based case-control study of 4,721 ALL cases diagnosed between 1988 and 2008 (overlapping with [4]), the observed odds ratio was 0.97 (CI 0.87-1.08) for higher birth order versus first [6]. Similarly, a Californian record-based case-control study with 3,402 ALL cases aged 0-5 years from 1988 to 2007 (overlapping with [4,6]) showed nonsignificant odds ratios of 1.00, 0.95, and 0.91 for birth orders second, third, and fourth or higher, respectively, compared with firstborn children, but indicated some stronger decrease in non-Hispanic Whites compared with Hispanic Whites [7].…”

“…Many studies have investigated the possible association between birth order and risk of childhood cancer, although the evidence to date has been inconsistent [1,[4][5][6][7][8][9][10][11][12]. As birth order is relatively straightforward to record, either through routine data sources such as birth registries or through questionnaire-based studies, where it is generally acknowledged to be well reported [13], it has often been used as a surrogate marker for in utero and/or childhood exposures.…”