Perinatal and early life risk factors for childhood brain tumors: Is instrument-assisted delivery associated with higher risk?

Georgakis, Marios K.; Dessypris, Nick; Papadakis, Vassilios; Tragiannidis, Athanasios; Bouka, Evdoxia; Hatzipantelis, Emmanuel; Moschovi, Maria; Παπακωνσταντίνου, Ευγενία; Polychronopoulou, Sophia; Sgouros, Spyridon; Stiakaki, Eftichia; Pourtsidis, Apostolos; Ψαλτοπούλου, Θεοδώρα; Petridou, Eleni; Bourgioti, Charis; Dana, Helen; Papadopoulos, Savvas; Sfakianos, George; Themistocleous, Marios; Stefanaki, Kalliopi; Strantzia, Katerina; Zountsas, Basilios; Vakis, Antonios; Manolitsi, Katerina; Kelekis, Nikolaos; Papathanasiou, Mathilda; Gkantaifi, Areti; Koutzoglou, Michalis; Κoletsa, Triantafyllia; Nikas, Ioannis; Zacharoulis, Stergios; Prassopoulos, Panagiotis; Orfanides, George; Primikiris, Panagiotis; Zerris, Vasilios A.; Friehs, G; Vyziotis, Alex; Patsouris, E.

doi:10.1016/j.canep.2019.01.017

Cited by 14 publications

(12 citation statements)

References 48 publications

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“…4,5 Suspected risk factors involve exposure to pesticides, N-nitroso compounds, traffic pollution, parental occupational exposure, fetal growth, parental age, maternal smoking, alcohol use and nutritional status during pregnancy. [6][7][8][9][10] The peak of CNS tumors in childhood provides evidence that perinatal and early-life exposures may be implicated in their etiology. Season of birth, a surrogate of seasonal variations of exposure to environmental factors during the perinatal period, including infectious agents, pesticides, as well as maternal infections, diet and alcohol consumption during pregnancy, has been associated with increased risk of several diseases, such as multiple sclerosis, psychiatric conditions and carcinogenesis.…”

Section: Introductionmentioning

confidence: 99%

“…The few established risk factors include the ionizing radiation at medium or high doses, as well as several genetic syndromes, such as ataxia‐telangiectasia, Cowden syndrome, familial adenomatous polyposis, hereditary nonpolyposis‐related colorectal cancer, Li‐Fraumeni syndrome, Gorlin syndrome, neurofibromatosis Types 1 and 2, multiple endocrine neoplasia Type 1, tuberous sclerosis complex, von Hippel–Lindau disease and Turcot syndrome . Suspected risk factors involve exposure to pesticides, N ‐nitroso compounds, traffic pollution, parental occupational exposure, fetal growth, parental age, maternal smoking, alcohol use and nutritional status during pregnancy …”

Section: Introductionmentioning

confidence: 99%

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Birth seasonality of childhood central nervous system tumors: Analysis of primary data from 16 Southern‐Eastern European population‐based registries

Karalexi

Dessypris

Georgakis

et al. 2020

Intl Journal of Cancer

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Season of birth, a surrogate of seasonal variation of environmental exposures, has been associated with increased risk of several cancers. In the context of a Southern-Eastern Europe (SEE) consortium, we explored the potential association of birth seasonality with childhood (0-14 years) central nervous system (CNS) tumors. Primary CNS tumor cases (n = 6,014) were retrieved from 16 population-based SEE registries (1983-2015). Poisson regression and meta-analyses on birth season were performed in nine countries with available live birth data (n = 4,987). Subanalyses by birth month, age, gender and principal histology were also conducted. Children born during winter were at a slightly increased risk of developing a CNS tumor overall [incidence rate ratio (IRR): 1.06, 95% confidence intervals (CI): 0.99-1.14], and of embryonal histology specifically (IRR: 1.13, M.A.K. and N.D. contributed equally to this work Additional Supporting Information may be found in the online version of this article.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Birth seasonality of childhood central nervous system tumors: Analysis of primary data from 16 Southern‐Eastern European population‐based registries

Karalexi

Dessypris

Georgakis

et al. 2020

Intl Journal of Cancer

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“…In our study, infants delivered with vaginal forceps or vacuum showed a higher risk of developing CNS tumors, whereas those born by cesarean had a higher risk of death. An elevated risk of pediatric brain tumors associated with forceps or vacuum assisted vaginal delivery has been previously reported by two small studies 18 , 19 , but not in a third study 20 . There is evidence of associations between instrument-assisted delivery and increased risk of head injury 21 , 22 , which in turn is associated with an elevated risk of brain tumors in adults 23 , 24 .…”

Section: Discussionmentioning

confidence: 82%

Maternal and perinatal factors are associated with risk of pediatric central nervous system tumors and poorer survival after diagnosis

Fahmideh

Peckham‐Gregory

Schraw

et al. 2021

Sci Rep

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Central nervous system (CNS) tumors are the most common solid tumors in children. Findings on the role of maternal and perinatal factors on the susceptibility or outcome of these tumors are inconclusive. Therefore, we investigated the association between these early-life factors, risk, and survival of pediatric CNS tumors, using data from one of the world’s largest and most diverse cancer registries. Information on pediatric CNS tumor cases (n = 1950) for the period 1995–2011 was obtained from the Texas Cancer Registry. Birth certificate controls were frequency-matched on birth year at a ratio of 10:1 for the same period. Evaluated maternal and perinatal variables were obtained from birth records. Unconditional logistic regression was used to generate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for etiological factors. Additionally, Cox proportional hazards regression was employed to assess adjusted hazard ratios (HRs) and 95% CIs for survival factors. The results indicated that Hispanic and non-Hispanic black mothers were less likely to have children with CNS tumors compared to non-Hispanic white mothers (OR 0.88 [95% CI 0.78–0.98] P-value = 0.019; OR 0.79 [95% CI 0.67–0.93 P-value = 0.004], respectively). Infants born large for gestational age (OR 1.26 [95% CI 1.07–1.47] P-value = 0.004) and those delivered pre-term (OR 1.19 [95% CI 1.04–1.38] P-value = 0.013) showed an increased risk of CNS tumors. Infants born by vaginal forceps or vacuum delivery had a higher risk of CNS tumors compared to those born by spontaneous vaginal delivery (OR 1.35 [95% CI 1.12–1.62] P-value = 0.002). Additionally, offspring of Hispanic and non-Hispanic black mothers showed a higher risk of death (HR 1.45 [95% CI 1.16–1.80] P-value = 0.001; HR 1.53 [95% CI 1.12–2.09] P-value = 0.008, respectively). Infants born by cesarean had a higher risk of death compared to those delivered vaginally (HR 1.28 [95% CI 1.05–1.57] P-value = 0.016). These findings indicate the important role of maternal and perinatal characteristics in the etiology and survival of these clinically significant malignancies.

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“…Older mothers have also more chronic diseases, such as hypothyroidism [ 34 ]. The role of parity is not as clear—there are reports of increased risk for childhood cancer increasing with parity [ 42 , 43 ], but also opposite results have been presented [ 44 , 45 ]. Parity increases with maternal age.…”

Section: Methodsmentioning

confidence: 99%

Maternal Thyroid Disease and the Risk of Childhood Cancer in the Offspring

Seppala

Madanat‐Harjuoja

Leinonen

et al. 2021

Cancers

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Maternal thyroid disease, especially hypothyroidism, affects pregnancy and its outcome. In-utero exposure to autoimmune thyroid disease has been reported to associate with childhood ALL in the offspring. We evaluated the risk of childhood cancer in the offspring following exposure to maternal thyroid disease in a case-control setting using registry data. All patients with their first cancer diagnosis below the age of 20 years were identified from the Finnish Cancer Registry (n = 2037) and matched for sex and birth year at a 1:5 ratio to population controls identified from the Medical Birth Registry (n = 10,185). We collected national information on maternal thyroid disease from the Medical Birth Registry, Care Register for Health Care, Register for Reimbursed Drug Purchases and Register of Special Reimbursements. We used conditional logistic regression to analyze childhood cancer risk in the offspring. The adjusted OR for any childhood cancer was 1.41 (95%, CI 1.00–2.00) comparing the offspring of mothers with hypothyroidism and those with normal thyroid function. The risk of lymphomas was increased (adjusted OR for maternal hypothyroidism 3.66, 95%, CI 1.29–10.38). The results remained stable when mothers with cancer history were excluded from the analyses. Maternal hypothyroidism appears to be associated with an increased risk for childhood lymphoma in the offspring. The association exists even after excluding possible familial cancers.

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Perinatal and early life risk factors for childhood brain tumors: Is instrument-assisted delivery associated with higher risk?

Cited by 14 publications

References 48 publications

Birth seasonality of childhood central nervous system tumors: Analysis of primary data from 16 Southern‐Eastern European population‐based registries

Birth seasonality of childhood central nervous system tumors: Analysis of primary data from 16 Southern‐Eastern European population‐based registries

Maternal and perinatal factors are associated with risk of pediatric central nervous system tumors and poorer survival after diagnosis

Maternal Thyroid Disease and the Risk of Childhood Cancer in the Offspring

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