Parental and infant characteristics and childhood leukemia in Minnesota

Abstract

BackgroundLeukemia is the most common childhood cancer. With the exception of Down syndrome, prenatal radiation exposure, and higher birth weight, particularly for acute lymphoid leukemia (ALL), few risk factors have been firmly established. Translocations present in neonatal blood spots and the young age peak of diagnosis suggest that early-life factors are involved in childhood leukemia etiology.MethodsWe investigated the association between birth characteristics and childhood leukemia through linkage of the Minnesota birth and cancer registries using a case-cohort study design. Cases included 560 children with ALL and 87 with acute myeloid leukemia (AML) diagnoses from 28 days to 14 years. The comparison group was comprised of 8,750 individuals selected through random sampling of the birth cohort from 1976–2004. Cox proportional hazards regression specific for case-cohort studies was used to compute hazard ratios (HR) and 95% confidence intervals (CIs).ResultsMale sex (HR = 1.41, 95% CI 1.16–1.70), white race (HR = 2.32, 95% CI 1.13–4.76), and maternal birth interval ≥ 3 years (HR = 1.31, 95% CI 1.01–1.70) increased ALL risk, while maternal age increased AML risk (HR = 1.21/5 year age increase, 95% CI 1.0–1.47). Higher birth weights (>3798 grams) (HRALL = 1.46, 1.08–1.98; HRAML = 1.97, 95% CI 1.07–3.65), and one minute Apgar scores ≤ 7 (HRALL = 1.30, 95% CI 1.05–1.61; HRAML = 1.62, 95% CI 1.01–2.60) increased risk for both types of leukemia. Sex was not a significant modifier of the association between ALL and other covariates, with the exception of maternal education.ConclusionWe confirmed known risk factors for ALL: male sex, high birth weight, and white race. We have also provided data that supports an increased risk for AML following higher birth weights, and demonstrated an association with low Apgar scores.

Birth weight, sex and childhood cancer: A report from the United Kingdom Childhood Cancer Study

“…Again, this observation was confirmed in the data presented in this report. However, whilst differential sex-specific fetal growth patterns have been widely studied [19][20][21][22], the reasons why childhood haematological malignancy is more likely to occur in boys than girls has been addressed far less frequently in relation to their weight at birth [7,[23][24][25][26][27]. Interestingly, the male incidence excess is maintained throughout life, with male rates exceeding female rates across the majority of myeloid and lymphoid subtypesoften by as much as 2-3 times [28].…”

Cancer Risk in Children and Young Adults Conceived by In Vitro Fertilization

“…Low maternal age (Ͻ20) was associated with an increased risk for acute leukemia, 7 whereas high maternal age had no effect in another study 12 but was associated with acute myeloid leukemia in 1 study. 13 We saw no certain maternal age effect on the risk for cancer in the offspring. The putative effect on acute myeloid leukemia seems not to be of importance in our study, because only 1 such case occurred among the cancers in children who were born after IVF.…”

Maternal smoking during pregnancy and childhood cancer in New South Wales: a record linkage investigation

“…These adverse outcomes may have lifelong consequences and result in higher risk of adult morbidity of the child [10]. In addition, higher birth weight may also be associated with childhood cancer [11][12][13][14].…”