Perinatal risk factors for neuroblastoma

Abstract

Neuroblastoma is the most common cancer among infants, suggesting an etiologic role for prenatal factors. In this case-cohort study, neuroblastoma cases (n = 529) diagnosed between 1985 and 2001 were identified from the New York State Cancer Registry and were matched to the electronic birth records for 1983-2001 from New York State and New York City. Controls (n = 12,010) were selected from the same birth cohorts. Analysis was stratified by age at diagnosis, with one to six months (younger infants), seven to 18 months (older infants), and older than 18 months (older children) analyzed separately. Perinatal exposure data was obtained from the birth certificates. No risk factors were identified to be consistently associated with risk across all three age groups. Generally, more risk factors were identified as associated with neuroblastoma among younger infants relative to older ages, including high birth weight, heavier maternal gestational weight gain, maternal hypertension, older maternal age, ultrasound, and respiratory distress. Among older infants, low birth weight was associated with increased risk while heavier maternal gestational weight gain was protective. In the oldest age group, first born status, primary cesarean delivery, prolonged labor and premature rupture of the membranes were associated with increased risk.

Perinatal characteristics and risk of neuroblastoma

“…Three studies have reported increased risks for a prior history of induced abortions, 6,18,27 while one study has reported a decreased risk for 2 or more prior therapeutic abortions. 20 Maternal history of any fetal loss or miscarriage specifically has been positively associated with NB in some studies, 7,9,10,18,20 but not in others. 6,17,19,27 Results from our study are also inconsistent with a significant increased risk for a history of one, but not 2 fetal losses; the latter result could be due to low power to detect a significant association or to random variation.…”

“…No definitive risk factors for NB have been identified with inconsistent associations reported for most previously examined exposures. Studies have examined prenatal exposure to maternal tobacco, [4][5][6][7][8] alcohol, 4,5,7,9,10 maternal hair dye 5,11 and drug-use. 5,7,[12][13][14][15] Other commonly examined exposures include those pertaining to sociodemographics, reproductive and pregnancy history, labor and delivery, and infant characteristics.…”

Maternal Prenatal Weight Gain and Autism Spectrum Disorders

“…15,16 Prepregnancy BMI and pregnancy weight gain have been found to correlate with maternal prenatal hormone levels [17][18][19][20] and hormonemediated cancer risk in offspring. 11,12,14,21,22 Data from the Utah Pregnancy Risk Assessment Monitoring System from 2000 through 2005 indicate a 19% rise in excessive pregnancy weight gain 23 ; these data also show that during the same time period, the proportion of women who were obese before pregnancy rose 25%. 24 Maternal BMI and gestational weight gain have previously been associated with increased risk for developmental disability.…”

Cesarean Section and Chronic Immune Disorders

“…3 Even though the World Health Organization recommends cesarean delivery as indicated choice of delivery mode in less than 15% of births, 4 many developed countries have a much higher prevalence, pointing toward a less strict medical indication for the procedure. 5,6 Cesarean delivery has been linked to the development of asthma and allergic rhinitis, [7][8][9][10] as well as other immune disorders [11][12][13][14][15][16] in the offspring.…”

“…Previous studies have revealed individual disorders generally showing associations between cesarean delivery and asthma and allergy, 7-10 inflammatory bowel disease, 11 celiac disease, 12,13 type 1 diabetes, 14 and cancers 15,16 in the offspring. Another register-based study has associated cesarean delivery with a wide range of diagnoses.…”