Maternal diabetes and risk of childhood acute lymphoblastic leukaemia in the offspring

Søegaard, Signe Holst; Rostgaard, Klaus; Kamper-Jørgensen, Mads; Schmiegelow, Kjeld; Hjalgrim, Henrik

doi:10.1038/bjc.2017.351

Cited by 16 publications

(19 citation statements)

References 30 publications

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“…Maternal type 1, 2 and gestational diabetes all appear to have an association with childhood cancer in the offspring . The association between maternal diabetes and childhood cancer is most convincing for acute lymphoblastic leukemia (ALL), but with only few studies differentiating pregestational from gestational diabetes . Whether modifiable factors affecting the anthropometrics at birth, such as maternal diabetes and diabetes medication, may impact childhood carcinogenesis, remains to be delineated.…”

Section: Introductionsupporting

confidence: 92%

“…In our study, the risk for ALL seemed to be increased in offspring exposed to maternal pregestational diabetes. Importantly, and after more accurate exposure definition and classification with multiple information sources, we found the risk for any childhood cancer to be increased especially for gestational diabetes …”

Section: Discussionmentioning

confidence: 65%

“…Previous studies including data on maternal medication have been hampered by small sample size, or have not included the possible impact of medication in the analyses . Despite the small sample size, our data do suggest a possible risk‐reducing impact of maternal medication for gestational diabetes on the incidence of childhood cancer in the offspring.…”

Section: Discussionmentioning

confidence: 65%

“…For other cancers, the results were inconclusive due to a small number of cases. Results from a recent Danish study exploring the influence of maternal diabetes on the risk of childhood ALL found the risk to be increased by at least twofold …”

Section: Discussionmentioning

confidence: 85%

“…Our nationwide and population‐based study combines an exceedingly comprehensive set of information on maternal morbidity, perinatal history and cancers among the offspring before the child's 20th birthday. In the setting of maternal diabetes and the risk for cancer at an early age, our study is the first to suggest a possible, risk‐reducing effect posed by the medication shedding additional light on the background of a putative, biological association between the two …”

Section: Discussionmentioning

confidence: 99%

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Maternal diabetes and risk of childhood cancer in the offspring

Seppala

Vettenranta

Pitkäniemi

et al. 2019

Intl Journal of Cancer

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An association between maternal diabetes, its medication and childhood cancer has not been previously explored in a registrybased setting. With a case-control design, we aimed to explore whether maternal diabetes is associated with an increased risk of childhood cancer in the offspring. Combining data from population-based registries, we analyzed a total of 2,029 cases, that is, persons with childhood cancer diagnosed under the age of 20 years between years 1996-2014 and a total of 10,103 matched population controls. The mothers of the cases/controls and their diagnoses of diabetes (DM) before/during pregnancy as well as their insulin/metformin prescriptions during pregnancy were identified. Conditional logistic regression modeling was used to analyze the risk of childhood cancer. The OR for childhood cancer among those exposed to any maternal diabetes was 1.32 (95% CI 1.14-1.54) compared to the offspring of the nondiabetic mothers. The effect of maternal diabetes on the risk of childhood cancer remained elevated even after adjusting for maternal age, parity and smoking. Our data suggest that maternal diabetes medication may reduce the risk for childhood cancer (adjusted OR 0.83, 95% CI 0.36-1.94), especially in gestational diabetes (adjusted OR 0.26, 95% CI 0.05-1.25), compared to the diabetic mothers without medication. The risk of childhood leukemia was significantly higher among children exposed to any maternal diabetes (OR 1.36, CI 1.04-1.77) compared to the unexposed. Maternal diabetes appears to be associated with an increased risk of childhood cancer in the offspring. The possible risk-reducing effect of an exposure to diabetes medication on offspring cancer risk warrants further investigation.Additional Supporting Information may be found in the online version of this article.

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Section: Introductionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Maternal diabetes and risk of childhood cancer in the offspring

Seppala

Vettenranta

Pitkäniemi

et al. 2019

Intl Journal of Cancer

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Exclusive Breastfeeding Duration and Risk of Childhood Cancers

Søegaard,

Andersen,

Rostgaard

et al. 2024

JAMA Netw Open

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ImportanceBreastfeeding has been suggested to protect against childhood cancers, particularly acute lymphoblastic leukemia (ALL). However, the evidence stems from case-control studies alone.ObjectiveTo investigate whether longer duration of exclusive breastfeeding is associated with decreased risk of childhood ALL and other childhood cancers.Design, Setting, and ParticipantsThis population-based cohort study used administrative data on exclusive breastfeeding duration from the Danish National Child Health Register. All children born in Denmark between January 2005 and December 2018 with available information on duration of exclusive breastfeeding were included. Children were followed up from age 1 year until childhood cancer diagnosis, loss to follow-up or emigration, death, age 15 years, or December 31, 2020. Data were analyzed from March to October 2023.ExposureDuration of exclusive breastfeeding in infancy.Main Outcomes and MeasuresAssociations between duration of exclusive breastfeeding and risk of childhood cancer overall and by subtypes were estimated as adjusted hazard ratios (AHRs) with 95% CIs using stratified Cox proportional hazards regression models.ResultsA total of 309 473 children were included (51.3% boys). During 1 679 635 person-years of follow-up, 332 children (0.1%) were diagnosed with cancer at ages 1 to 14 years (mean [SD] age at diagnosis, 4.24 [2.67] years; 194 boys [58.4%]). Of these, 124 (37.3%) were diagnosed with hematologic cancers (81 [65.3%] were ALL, 74 [91.4%] of which were B-cell precursor [BCP] ALL), 44 (13.3%) with central nervous system tumors, 80 (24.1%) with solid tumors, and 84 (25.3%) with other and unspecified malignant neoplasms. Compared with exclusive breastfeeding duration of less than 3 months, exclusive breastfeeding for 3 months or longer was associated with a decreased risk of hematologic cancers (AHR, 0.66; 95% CI, 0.46-0.95), which was largely attributable to decreased risk of BCP-ALL (AHR, 0.62; 95% CI, 0.39-0.99), but not with risk of central nervous system tumors (AHR, 0.96; 95% CI, 0.51-1.88) or solid tumors (AHR, 0.87; 95% CI, 0.55-1.41).Conclusions and RelevanceIn this cohort study, longer duration of exclusive breastfeeding was associated with reduced risk of childhood BCP-ALL, corroborating results of previous case-control investigations in this field. To inform future preemptive interventions, continued research should focus on the potential biologic mechanisms underlying the observed association.

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Maternal diabetes and risk of childhood malignancies in the offspring: a systematic review and meta-analysis of observational studies

Yan

Wang

et al. 2020

Acta Diabetol

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Maternal diabetes and risk of childhood acute lymphoblastic leukaemia in the offspring

Cited by 16 publications

References 30 publications

Maternal diabetes and risk of childhood cancer in the offspring

Maternal diabetes and risk of childhood cancer in the offspring

Exclusive Breastfeeding Duration and Risk of Childhood Cancers

Maternal diabetes and risk of childhood malignancies in the offspring: a systematic review and meta-analysis of observational studies

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