Maternal and Infant Birth Characteristics and Hepatoblastoma

Abstract

Hepatoblastoma is a rare embryonal tumor with unknown etiology. The authors conducted a case-cohort study using public health surveillance data sets to examine perinatal risk factors for hepatoblastoma. Hepatoblastoma cases (n = 58) diagnosed between 1985 and 2001 were identified from the New York State Cancer Registry and were matched to electronic birth records for 1985-2001 from New York State, excluding New York City. Controls (n = 6,056) were selected from the birth cohorts for the same years. Having a birth weight less than 1,000 g was associated with a strongly increased risk of hepatoblastoma (relative risk (RR) = 56.9, 95% confidence interval (CI): 24.0, 130.7). After adjustment for birth weight, a moderately increased risk of hepatoblastoma was found for younger maternal age (<20 years vs. 20-29 years: RR = 2.5, 95% CI: 1.0, 5.5), presumptive use of infertility treatment (RR = 9.2, 95% CI: 2.1, 31.5), maternal smoking (RR = 2.1, 95% CI: 1.0, 4.2), and higher maternal prepregnancy body mass index (body mass index of 25-29 vs. 20-24: RR = 2.9, 95% CI: 1.2, 7.6).

Perinatal risk factors for hepatoblastoma

“…Very low birth weight has emerged over the past 15 years as a potent risk factor for hepatoblastoma (Feusner et al, 1998;Tanimura et al, 1998;Reynolds et al, 2004;Ansell et al, 2005;McLaughlin et al, 2006). We have now confirmed this association in the paediatric population of Minnesota.…”

“…Similar findings were not noted in studies in California (Reynolds et al, 2004) and New York (McLaughlin et al, 2006), and there was not an elevated rate in Ho Chi Minh City, Vietnam (Nguyen et al, 2000). Our observation was therefore novel and independent of birth weight.…”

“…Limited multivariate analyses in this study and others (Reynolds et al, 2004;McLaughlin et al, 2006) have begun to tease apart the role of other characteristics from that of VLBW. Notably, preterm birth (o37 weeks) was not an independent risk factor in any of the studies after adjustment.…”

“…Although its causes are mostly obscure, it is apparent that very low birth weight (VLBW), generally defined as o1500 g, is a potent risk factor (Tanimura et al, 1998;Reynolds et al, 2004;Ansell et al, 2005;McLaughlin et al, 2006). Hepatoblastoma incidence doubled between 1975 and 1999 (Spector et al, 2004), possibly related to the concomitant rise in prevalence of VLBW infants and a marked drop in their mortality (CDC, 2002).…”

Maternal use of fertility drugs and risk of cancer in children—A nationwide population‐based cohort study in Denmark

“…13 Nevertheless, few studies have reported the incidence of cancer in the already large and growing population of children born after fertility treatment and the results are inconsistent. While some studies showed increased risks for all cancers 14 and for specific types of cancer, such as retinoblastoma, 15 neuroblastoma, 6 leukemia, [16][17][18] and hepatoblastoma, 19,20 others found no association. [21][22][23][24][25][26][27][28][29][30][31][32] However, the main part of these studies are characterized by small sample sizes, short follow-up periods and lack of information on the use of fertility drugs.…”