Maternal Obesity, Birth Size, and Risk of Childhood Cancer Development

Abstract

Infants and children are particularly vulnerable to in utero and early-life exposures. Thus, a mother’s exposures before and during pregnancy could have important consequences for her child’s health, including cancer development. We examined whether birth certificate–derived maternal anthropometric characteristics were associated with increased risk of subsequent childhood cancer development, accounting for established maternal and infant risk factors. Pennsylvania birth and cancer registry files were linked by the state Department of Health, yielding a virtual cohort of births and childhood cancers from 2003 through 2016. The analysis included 1,827,875 infants (13,785,309 person-years at risk), with 2,352 children diagnosed with any cancer and 747 with leukemia before age 14 years. Children born to mothers with a body mass index (weight (kg)/height (m)2) of ≥40 had a 57% (95% confidence interval: 12, 120) higher leukemia risk. Newborn size of ≥30% higher than expected was associated with 2.2-fold and 1.8-fold hazard ratios for total childhood cancer and leukemia, respectively, relative to those with expected size. Being <30% below expected size also increased the overall cancer risk (P for curvilinearity < 0.0001). Newborn size did not mediate the association between maternal obesity and childhood cancer. The results suggest a significant role of early-life exposure to maternal obesity- and fetal growth–related factors in childhood cancer development.

Parental education and cancer mortality in children, adolescents, and young adults: A case‐cohort study within the 2011 Italian census cohort

“…These results may arise from different distributions of potential risk factors for juvenile cancers-particularly leukemia-across levels of parental education, such as exposure of the fetus and child to selected carcinogens, air pollution, and parental smoking as well as maternal obesity and low and high birthweight. [29][30][31] Moreover, low parental education may have also affected the survival of young patients with cancer, with less educated parents not having adequate knowledge and material resources to cope with the burden of the disease and treatment.…”

Phenotypic and Epigenetic Adaptations of Cord Blood CD4+ T Cells to Maternal Obesity

“…In particular, babies born to mothers with obesity are more susceptible to infectious diseases (1)(2)(3), with increased risks for bacterial sepsis and necrotizing enterocolitis that require admission to the neonatal intensive care unit (4,5). Additionally, offspring of mothers with obesity exhibit increased susceptibility to respiratory diseases (wheezing and childhood asthma (6)(7)(8)), cancer (9), and metabolic diseases (type-2 diabetes and cardiovascular diseases) (3).…”

Pre‐pregnancy obesity and childhood malignancies: A population‐based cohort study

“…linked data from the Pennsylvania birth and cancer registries between 2003 and 2016 and found 2352 children diagnosed with cancer and 747 with leukemia up to the age of 14. According to their results, only children born to mothers with morbid obesity (BMI > 40) were at higher for any cancer and specifically leukemia 28 . In our study, we found 90 cases of childhood leukemia and report no significant correlation between pre‐pregnancy obesity (BMI ≥ 30) and future risk for leukemia.…”

“…Despite limited literature, childhood leukemia has been the focus of several studies in the past. These studies found contradicting results, with some showing no significant correlation to the future risk of childhood leukemia, 24,29,38 whereas two studies showing increased risk 27,28 . Contreras et al.…”