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Benítez L, Castro-Barquero S, Crispi F, Youssef L, Crovetto F, Fischer U, Kameri E, Bueno C, Camos M, Menéndez P, Heinäniemi M, Borkhardt A, Gratacós E. Maternal Lifestyle and Prenatal Risk Factors for Childhood Leukemia: A Review of the Existing Evidence. Fetal Diagn Ther 2024; 51:395-410. [PMID: 38710162 DOI: 10.1159/000539141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/12/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Acute leukemia is the most common pediatric cancer, with an incidence peak at 2-5 years of age. Despite the medical advances improving survival rates, children suffer from significant side effects of treatments as well as its high social and economic impact. The frequent prenatal origin of this developmental disease follows the two-hit carcinogenesis model established in the 70s: a first hit in prenatal life with the creation of genetic fusion lesions or aneuploidy in hematopoietic progenitor/stem cells, and usually a second hit in the pediatric age that converts the preleukemic clone into clinical leukemia. Previous research has mostly focused on postnatal environmental factors triggering the second hit. SUMMARY There is scarce evidence on prenatal risk factors associated with the first hit. Mainly retrospective case-control studies suggested several environmental and lifestyle determinants as risk factors. If these associations could be confirmed, interventions focused on modifying prenatal factors might influence the subsequent risk of leukemia during childhood and reveal unexplored research avenues for the future. In this review, we aim to comprehensively summarize the currently available evidence on prenatal risk factors for the development of childhood leukemia. According to the findings of this review, parental age, ethnicity, maternal diet, folate intake, alcohol consumption, X-ray exposure, pesticides, perinatal infections, and fetal growth may have a significant role in the appearance of preleukemic lesions during fetal life. Other factors such as socioeconomic status, consumption of caffeinated beverages, and smoking consumption have been suggested with inconclusive evidence. Additionally, investigating the association between prenatal factors and genetic lesions associated with childhood leukemia at birth is crucial. Prospective studies evaluating the link between lifestyle factors and genetic alterations could provide indirect evidence supporting new research avenues for leukemia prevention. Maternal diet and lifestyle factors are modifiable determinants associated with adverse perinatal outcomes that could be also related to preleukemic lesions. KEY MESSAGES Parental age, ethnicity, maternal diet, folate intake, alcohol consumption, X-ray exposure, pesticides, perinatal infections, and fetal growth may have a significant role in the appearance of preleukemic lesions during fetal life. Dedicating efforts to studying maternal lifestyle during pregnancy and its association with genetic lesions leading to childhood leukemia could lead to novel prevention strategies.
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Affiliation(s)
- Leticia Benítez
- BCNatal Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain,
| | - Sara Castro-Barquero
- BCNatal Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Fàtima Crispi
- BCNatal Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Lina Youssef
- BCNatal Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Josep Carreras Leukemia Research Institute and Department of Biomedicine, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Francesca Crovetto
- BCNatal Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ute Fischer
- Department of Pediatric Oncology, Hematology and Clinical Immunology, University Children's Hospital, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, Düsseldorf, Germany
| | - Ersen Kameri
- Department of Pediatric Oncology, Hematology and Clinical Immunology, University Children's Hospital, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Clara Bueno
- Stem Cell Biology, Developmental Leukemia and Immunotherapy Group, Josep Carreras Leukemia Research Institute, Barcelona, Spain
- RICORS-TERAV Network, ISCIII, Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Barcelona, Spain
| | - Mireia Camos
- Department of Pediatric Oncology and Hematology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Pablo Menéndez
- Stem Cell Biology, Developmental Leukemia and Immunotherapy Group, Josep Carreras Leukemia Research Institute, Barcelona, Spain
- RICORS-TERAV Network, ISCIII, Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Barcelona, Spain
- Department of Biomedicine, School of Medicine, University of Barcelona, Barcelona, Spain
- Instituciò Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Merja Heinäniemi
- Institute of Biomedicine, School of Medicine, University of Finland, Kuopio, Finland
| | - Arndt Borkhardt
- Department of Pediatric Oncology, Hematology and Clinical Immunology, University Children's Hospital, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, Düsseldorf, Germany
| | - Eduard Gratacós
- BCNatal Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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Hu Z, Ye J, Shi S, Luo C, Wang T, Liu Y, Ye J, Sun X, Ke Y, Hou C. Maternal smoking, consumption of alcohol, and caffeinated beverages during pregnancy and the risk of childhood brain tumors: a meta-analysis of observational studies. BMC Public Health 2024; 24:1238. [PMID: 38711042 PMCID: PMC11071245 DOI: 10.1186/s12889-024-18569-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/11/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND We conducted this meta-analysis to investigate the potential association between maternal smoking, alcohol and caffeinated beverages consumption during pregnancy and the risk of childhood brain tumors (CBTs). METHODS A thorough search was carried out on PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Internet to identify pertinent articles. Fixed or random effects model was applied to meta-analyze the data. RESULTS The results suggested a borderline statistically significant increased risk of CBTs associated with maternal smoking during pregnancy (OR 1.04, 95% CI 0.99-1.09). We found that passive smoking (OR 1.12, 95% CI 1.03-1.20), rather than active smoking (OR 1.00, 95% CI 0.93-1.07), led to an increased risk of CBTs. The results suggested a higher risk in 0-1 year old children (OR 1.21, 95% CI 0.94-1.56), followed by 0-4 years old children (OR 1.12, 95% CI 0.97-1.28) and 5-9 years old children (OR 1.11, 95% CI 0.95-1.29). This meta-analysis found no significant association between maternal alcohol consumption during pregnancy and CBTs risk (OR 1.00, 95% CI 0.80-1.24). An increased risk of CBTs was found to be associated with maternal consumption of caffeinated beverages (OR 1.16, 95% CI 1.07-1.26) during pregnancy, especially coffee (OR 1.18, 95% CI 1.00-1.38). CONCLUSIONS Maternal passive smoking, consumption of caffeinated beverages during pregnancy should be considered as risk factors for CBTs, especially glioma. More prospective cohort studies are warranted to provide a higher level of evidence.
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Affiliation(s)
- Zihao Hu
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 510282, Guangzhou, People's Republic of China
| | - Jianbo Ye
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 510282, Guangzhou, People's Republic of China
| | - Shenbao Shi
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 510282, Guangzhou, People's Republic of China
| | - Chuangcai Luo
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 510282, Guangzhou, People's Republic of China
| | - Tianwei Wang
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 510282, Guangzhou, People's Republic of China
| | - Yang Liu
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 510282, Guangzhou, People's Republic of China
| | - Jing'an Ye
- Department of Neurosurgery, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People's Hospital), 523059, Dongguan, People's Republic of China
| | - Xinlin Sun
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 510282, Guangzhou, People's Republic of China.
| | - Yiquan Ke
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 510282, Guangzhou, People's Republic of China.
| | - Chongxian Hou
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 510282, Guangzhou, People's Republic of China.
- Department of Neurosurgery, Shenzhen People's Hospital (The Second Clinical Medical College of Jinan University; The First Affiliated Hospital of Southern University of Science and Technology), 518020, Shenzhen, People's Republic of China.
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Onyije FM, Dolatkhah R, Olsson A, Bouaoun L, Deltour I, Erdmann F, Bonaventure A, Scheurer ME, Clavel J, Schüz J. Risk factors for childhood brain tumours: A systematic review and meta-analysis of observational studies from 1976 to 2022. Cancer Epidemiol 2024; 88:102510. [PMID: 38056243 PMCID: PMC10835339 DOI: 10.1016/j.canep.2023.102510] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Childhood brain tumours (CBTs) are the leading cause of cancer death in children under the age of 20 years globally. Though the aetiology of CBT remains poorly understood, it is thought to be multifactorial. We aimed to synthesize potential risk factors for CBT to inform primary prevention. METHODS We conducted a systematic review and meta-analysis of epidemiological studies indexed in the PubMed, Web of Science, and Embase databases from the start of those resources through 27 July 2023. We included data from case-control or cohort studies that reported effect estimates for each risk factor around the time of conception, during pregnancy and/or during post-natal period. Random effects meta-analysis was used to estimate summary effect sizes (ES) and 95% confidence intervals (CIs). We also quantified heterogeneity (I2) across studies. FINDINGS A total of 4040 studies were identified, of which 181 studies (85 case-control and 96 cohort studies) met our criteria for inclusion. Of all eligible studies, 50% (n = 91) were conducted in Europe, 32% (n = 57) in North America, 9% (n = 16) in Australia, 8% (n = 15) in Asia, 1% (n = 2) in South America, and none in Africa. We found associations for some modifiable risk factors including childhood domestic exposures to insecticides (ES 1.44, 95% CI 1.20-1.73) and herbicides (ES 2.38, 95% CI 1.31-4.33). Maternal domestic exposure to insecticides (ES 1.45, 95% CI 1.09-1.94), maternal consumption of cured meat (ES 1.51, 95% CI 1.05-2.17) and coffee ≥ 2 cups/day (ES 1.45, 95% 95% CI 1.07-1.95) during pregnancy, and maternal exposure to benzene (ES 2.22; 95% CI 1.01-4.88) before conception were associated with CBTs in case-control studies. Also, paternal occupational exposure to pesticides (ES 1.48, 95% CI 1.23-1.77) and benzene (ES 1.74, 95% CI 1.10-2.76) before conception and during pregnancy were associated in case-control studies and in combined analysis. On the other hand, assisted reproductive technology (ART) (ES 1.32, 95% CI 1.05-1.67), caesarean section (CS) (ES 1.12, 95% CI 1.01-1.25), paternal occupational exposure to paint before conception (ES 1.56, 95% CI 1.02-2.40) and maternal smoking > 10 cigarettes per day during pregnancy (ES 1.18, 95% CI 1.00-1.40) were associated with CBT in cohort studies. Maternal intake of vitamins and folic acid during pregnancy was inversely associated in cohort studies. Hormonal/infertility treatment, breastfeeding, child day-care attendance, maternal exposure to electric heated waterbed, tea and alcohol consumption during pregnancy were among those not associated with CBT in both case-control and cohort studies. CONCLUSION Our results should be interpreted with caution, especially as most associations between risk factors and CBT were discordant between cohort and case-control studies. At present, it is premature for any CBT to define specific primary prevention guidelines.
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Affiliation(s)
- Felix M Onyije
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, 69366 LYON CEDEX 07, France.
| | - Roya Dolatkhah
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, 69366 LYON CEDEX 07, France
| | - Ann Olsson
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, 69366 LYON CEDEX 07, France
| | - Liacine Bouaoun
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, 69366 LYON CEDEX 07, France
| | - Isabelle Deltour
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, 69366 LYON CEDEX 07, France
| | - Friederike Erdmann
- Research Group Aetiology and Inequalities in Childhood Cancer, Division of Childhood Cancer Epidemiology Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center Mainz, Langenbeckstraβe 1, 55131 Mainz, Germany
| | - Audrey Bonaventure
- Epidemiology of Childhood and Adolescent Cancers Team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Villejuif, France
| | - Michael E Scheurer
- Department of Pediatrics, Hematology-Oncology, Baylor College of Medicine and Texas Children's Hospital Cancer Center, Houston, TX, United States
| | - Jacqueline Clavel
- Epidemiology of Childhood and Adolescent Cancers Team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Villejuif, France; National Registry of Childhood Cancers, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, France; Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, 69366 LYON CEDEX 07, France
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Carter T, Schoenaker D, Adams J, Steel A. Paternal preconception modifiable risk factors for adverse pregnancy and offspring outcomes: a review of contemporary evidence from observational studies. BMC Public Health 2023; 23:509. [PMID: 36927694 PMCID: PMC10022288 DOI: 10.1186/s12889-023-15335-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND The preconception period represents transgenerational opportunities to optimize modifiable risk factors associated with both short and long-term adverse health outcomes for women, men, and children. As such, preconception care is recommended to couples during this time to enable them to optimise their health in preparation for pregnancy. Historically, preconception research predominately focuses on maternal modifiable risks and health behaviours associated with pregnancy and offspring outcomes; limited attention has been given to inform paternal preconception health risks and outcomes. This systematic review aims to advance paternal preconception research by synthesising the current evidence on modifiable paternal preconception health behaviours and risk factors to identify associations with pregnancy and/or offspring outcomes. METHODS Medline, Embase, Maternity and Infant care, CINAHL, PsycINFO, Scopus, and ISI Proceedings were searched on the 5th of January 2023, a date limit was set [2012-2023] in each database. A Google Scholar search was also conducted identifying all other relevant papers. Studies were included if they were observational, reporting associations of modifiable risk factors in the preconception period among males (e.g., identified as reproductive partners of pregnant women and/or fathers of offspring for which outcomes were reported) with adverse pregnancy and offspring outcomes. Study quality was assessed using the Newcastle-Ottawa Scale. Exposure and outcome heterogeneity precluded meta-analysis, and results were summarised in tables. RESULTS This review identified 56 cohort and nine case control studies. Studies reported on a range of risk factors and/or health behaviours including paternal body composition (n = 25), alcohol intake (n = 6), cannabis use (n = 5), physical activity (n = 2), smoking (n = 20), stress (n = 3) and nutrition (n = 13). Outcomes included fecundability, IVF/ISCI live birth, offspring weight, body composition/BMI, asthma, lung function, leukemia, preterm birth, and behavioural issues. Despite the limited number of studies and substantial heterogeneity in reporting, results of studies assessed as good quality showed that paternal smoking may increase the risk of birth defects and higher paternal BMI was associated with higher offspring birthweight. CONCLUSION The current evidence demonstrates a role of paternal preconception health in influencing outcomes related to pregnancy success and offspring health. The evidence is however limited and heterogenous, and further high-quality research is needed to inform clinical preconception care guidelines to support men and couples to prepare for a health pregnancy and child.
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Affiliation(s)
- Tristan Carter
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, 2006, Australia.
| | - Danielle Schoenaker
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jon Adams
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, 2006, Australia
| | - Amie Steel
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, 2006, Australia
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Sadeghmousavi S, Rezaei N, Hanaei S. Nutrition and Diet: A Double-Edged Sword in Development and Treatment of Brain Tumors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1394:153-180. [PMID: 36587387 DOI: 10.1007/978-3-031-14732-6_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Brain tumor (BT) is the second most common pediatric cancer, one of the most common cancers among adults, and the major cause of cancer-related morbidity and mortality worldwide. Both genetics and environment can contribute to BT induction. One of the environmental risks is diet which has not been proven as a certain hazard yet. The objective of the current chapter was to review the literature concerning both positive and negative effects of nutrition on BT risk.
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Affiliation(s)
- Shaghayegh Sadeghmousavi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Department of Immunology, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sara Hanaei
- Universal Scientific Education and Research Network (USERN), Tehran, Iran. .,Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Young SL, Steane SE, Kent NL, Reid N, Gallo LA, Moritz KM. Prevalence and Patterns of Prenatal Alcohol Exposure in Australian Cohort and Cross-Sectional Studies: A Systematic Review of Data Collection Approaches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13144. [PMID: 36293721 PMCID: PMC9603223 DOI: 10.3390/ijerph192013144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
This study sought to determine data collection approaches in Australian cohort studies and explore the potential impact on reported prenatal alcohol exposure (PAE) prevalence and patterns. Inclusion criteria were that studies related to a general Australian antenatal population where PAE was assessed and reported. Studies were excluded if they were not peer reviewed, examined the prevalence of PAE in pregnancies complicated by alcohol-use disorders, or were published in a language other than English. A systematic search of five electronic databases (PubMed, Embase, CINAHL, Web of Science, and Scopus) was conducted. Risk of bias was assessed using the Effective Public Health Practice Project quality assessment tool. Results were synthesised using MetaXL. Data from 16 separate birth cohorts (n = 78 articles) were included. Included cohorts were either general cohorts that included alcohol as a variable or alcohol-focused cohorts that were designed with a primary focus on PAE. PAE prevalence was estimated as 48% (95% CI: 38 to 57%). When subgroup analysis was performed, estimates of PAE prevalence when self-administered surveys and interviews were used for data collection were 53% (95% CI: 41% to 64%) and 43% (95% CI: 28% to 59%), respectively. Use of trained assessors was an influencing factor of the prevalence estimates when data were collected via interview. Alcohol-focused studies reported higher prevalence of PAE, regardless of method of survey administration. Where interviewer training is not possible, self-administered questionnaires will likely provide the most reliable PAE estimates. No funding sources are relevant to mention. Review was registered with PROSPERO (CRD42020204853).
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Affiliation(s)
- Sophia L. Young
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - Sarah E. Steane
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - Nykola L. Kent
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - Natasha Reid
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - Linda A. Gallo
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Petrie, QLD 4502, Australia
| | - Karen M. Moritz
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
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Luan M, Zhang X, Fang G, Liang H, Yang F, Song X, Chen Y, Yuan W, Miao M. Preconceptional paternal alcohol consumption and the risk of child behavioral problems: a prospective cohort study. Sci Rep 2022; 12:1508. [PMID: 35087204 PMCID: PMC8795263 DOI: 10.1038/s41598-022-05611-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 01/14/2022] [Indexed: 12/22/2022] Open
Abstract
Animal studies demonstrated that paternal alcohol exposure before conception increases the risk of adverse neurodevelopment in offspring, but limited evidence is known in humans. Based on Shanghai-Minhang Birth Cohort Study, we aimed to examine associations between preconceptional paternal alcohol consumption and child behavioral problems. Paternal alcohol consumption during the last 3 months before conception was obtained by maternal report. Children born to fathers who drank alcohol at least once a week were classified as exposed. Child behavioral problems were assessed using the Child Behavior Checklist (CBCL) at age of 2, 4, and 6. Negative binomial regression was used to estimate the rate ratio (RR) of CBCL raw scores in 796 offspring. The risks of rating scores on anxious/depressed were increased by 33% (RR 1.33, 95% CI 1.09, 1.61) and 37% (RR 1.37, 95% CI 1.02, 1.84) among boys in the exposed group at age of 4 and 6, respectively. We also found that risks of somatic complaints were increased by 18% (RR 1.18, 95%CI 1.00, 1.40) and 65% (RR 1.65, 95%CI 1.14, 2.38) among girls in the exposed group at age of 4 and 6. The increased risks of sleep problems (RR 1.25, 95% CI 1.00, 1.55) in girls at age 4, thought problems (RR 1.32, 95% CI 1.01, 1.73) in girls at age 6, rule-breaking behaviors (RR 1.35, 95% CI 1.09, 1.67) in boys at age 6 were also found. The risks of CBCL scores on anxious/depressed and sleep problems in girls at age 4, as well as the risks of somatic complaints and rule-breaking behaviors in boys at age 6 increased with the level of exposure to paternal alcohol consumption. Our findings provided preliminary evidence that preconceptional paternal alcohol consumption may increase risks of child behavioral problems.
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Affiliation(s)
- Min Luan
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), School of Public Health, Fudan University, Shanghai, 200237, China
| | - Xiaohua Zhang
- Minhang Maternal and Child Health Hospital, Shanghai, 201102, China
| | - Guanghong Fang
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, 779 Lao Hu Min Road, Shanghai, 200237, China
| | - Hong Liang
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, 779 Lao Hu Min Road, Shanghai, 200237, China
| | - Fen Yang
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, 779 Lao Hu Min Road, Shanghai, 200237, China
| | - Xiuxia Song
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, 779 Lao Hu Min Road, Shanghai, 200237, China
| | - Yao Chen
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, 779 Lao Hu Min Road, Shanghai, 200237, China
| | - Wei Yuan
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, 779 Lao Hu Min Road, Shanghai, 200237, China
| | - Maohua Miao
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, 779 Lao Hu Min Road, Shanghai, 200237, China.
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Liu Y, Nie B, Liu T, Zheng N, Liu Z, Shan B, Jiang L, Manyande A, Li X, Xu F, Wang J. Variations of Brain Functional Connectivity in Alcohol-Preferring and Non-Preferring Rats with Consecutive Alcohol Training or Acute Alcohol Administration. Brain Sci 2021; 11:brainsci11111474. [PMID: 34827473 PMCID: PMC8615902 DOI: 10.3390/brainsci11111474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022] Open
Abstract
Alcohol addiction is regarded as a series of dynamic changes to neural circuitries. A comparison of the global network during different stages of alcohol addiction could provide an efficient way to understand the neurobiological basis of addiction. Two animal models (P-rats screened from an alcohol preference family, and NP-rats screened from an alcohol non-preference family) were trained for alcohol preference with a two-bottle free choice method for 4 weeks. To examine the changes in the neural response to alcohol during the development of alcohol preference and acute stimulation, different trials were studied with resting-state fMRI methods during different periods of alcohol preference. The correlation coefficients of 28 regions in the whole brain were calculated, and the results were compared for alcohol preference related to the genetic background/training association. The variety of coherence patterns was highly related to the state and development of alcohol preference. We observed significant special brain connectivity changes during alcohol preference in P-rats. The comparison between the P- and NP-rats highlighted the role of genetic background in alcohol preference. The results of this study support the alterations of the neural network connection during the formation of alcohol preference and confirm that alcohol preference is highly related to the genetic background. This study could provide an effective approach for understanding the neurobiological basis of alcohol addiction.
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Affiliation(s)
- Yue Liu
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences—Wuhan National Laboratory for Optoelectronics, Wuhan 430071, China; (Y.L.); (T.L.); (N.Z.); (Z.L.)
| | - Binbin Nie
- Key Laboratory of Nuclear Radiation and Nuclear Energy Technology, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China; (B.N.); (B.S.)
| | - Taotao Liu
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences—Wuhan National Laboratory for Optoelectronics, Wuhan 430071, China; (Y.L.); (T.L.); (N.Z.); (Z.L.)
| | - Ning Zheng
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences—Wuhan National Laboratory for Optoelectronics, Wuhan 430071, China; (Y.L.); (T.L.); (N.Z.); (Z.L.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zeyuan Liu
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences—Wuhan National Laboratory for Optoelectronics, Wuhan 430071, China; (Y.L.); (T.L.); (N.Z.); (Z.L.)
| | - Baoci Shan
- Key Laboratory of Nuclear Radiation and Nuclear Energy Technology, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China; (B.N.); (B.S.)
| | - Lihong Jiang
- Magnetic Resonance Research Center, Yale University, New Haven, CT 06511, USA;
| | - Anne Manyande
- School of Human and Social Sciences, University of West London, Middlesex TW8 9GA, UK;
| | - Xihai Li
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China;
| | - Fuqiang Xu
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences—Wuhan National Laboratory for Optoelectronics, Wuhan 430071, China; (Y.L.); (T.L.); (N.Z.); (Z.L.)
- University of Chinese Academy of Sciences, Beijing 100049, China
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai 200031, China
- Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan 430074, China
- Correspondence: (F.X.); (J.W.)
| | - Jie Wang
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences—Wuhan National Laboratory for Optoelectronics, Wuhan 430071, China; (Y.L.); (T.L.); (N.Z.); (Z.L.)
- University of Chinese Academy of Sciences, Beijing 100049, China
- Correspondence: (F.X.); (J.W.)
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9
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Auger N, Goudie C, Low N, Healy-Profitós J, Lo E, Luu TM. Maternal use of illicit drugs, tobacco or alcohol and the risk of childhood cancer before 6 years of age. Drug Alcohol Depend 2019; 200:133-138. [PMID: 31129483 DOI: 10.1016/j.drugalcdep.2019.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Previous studies provide conflicting evidence of a link between maternal substance use and risk of childhood cancer. METHODS We analyzed a cohort of 785,438 newborns in Quebec (2006-2016). We identified infants whose mothers had problematic illicit drug, tobacco, or alcohol use before or during pregnancy. The primary outcomes were childhood hematopoietic cancer or solid tumors within 0-5 years of age. Using Cox proportional hazards models, we computed hazard ratios (HR) and 95% confidence intervals (CI) for the association between maternal substance use and childhood cancer, adjusted for potential confounders. RESULTS A total of 925 cases of cancer occurred during 3.5 million person-years of follow-up. Children exposed to any maternal substance use had marginally elevated cancer incidence rates compared with unexposed children (29.4 vs. 26.1 per 100,000 person-years). Maternal illicit drug use was associated with the risk of acute lymphoblastic leukemia (HR 1.63, 95% CI 0.79-3.36) and fibrosarcoma (HR 2.11, 95% CI 0.86-5.16). Maternal tobacco use was associated with acute myeloid leukemia (HR 2.01, 95% CI 0.72-5.60) and fibrosarcoma (HR 2.13, 95% CI 1.05-4.32), but a weak association with neuroblastoma (HR 1.21, 95% CI 0.61-2.40) and renal tumors (HR 1.14, 95% CI 0.42-3.13) also appeared to be present. CONCLUSIONS We found a potential association between maternal substance use and certain types of early childhood cancer. Although effects were modest, maternal substance use may contribute to some types of childhood cancer, especially leukemia and fibrosarcoma.
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Affiliation(s)
- Nathalie Auger
- University of Montreal Hospital Research Centre, School of Public Health, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.
| | - Catherine Goudie
- Department of Pediatrics, Division of Hematology-Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Nancy Low
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Jessica Healy-Profitós
- University of Montreal Hospital Research Centre, School of Public Health, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Ernest Lo
- Institut national de santé publique du Québec, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Sainte Justine Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada
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10
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Transplacental exposure to carcinogens and risks to children: evidence from biomarker studies and the utility of omic profiling. Arch Toxicol 2019; 93:833-857. [PMID: 30859261 DOI: 10.1007/s00204-019-02428-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/04/2019] [Indexed: 12/12/2022]
Abstract
The factors underlying the increasing rates and the geographic variation of childhood cancers are largely unknown. Epidemiological studies provide limited evidence for a possible role in the etiology of certain types of childhood cancer of the exposure of pregnant women to environmental carcinogens (e.g., tobacco smoke and pesticides); however, such evidence is inadequate to allow definitive conclusions. Complementary evidence can be obtained from biomarker-based population studies. Such studies have demonstrated that, following exposure of pregnant mothers, most environmental carcinogens reach the fetus and, in many cases, induce therein genotoxic damage which in adults is known to be associated with increased cancer risk, implying that environmental carcinogens may contribute to the etiology of childhood cancer. During recent years, intermediate disease biomarkers, obtained via omic profiling, have provided additional insights into the impact of transplacental exposures on fetal tissues which, in some cases, are also compatible with a precarcinogenic role of certain in utero exposures. Here we review the epidemiological and biomarker evidence and discuss how further research, especially utilizing high-density profiling, may allow a better evaluation of the links between in utero environmental exposures and cancer in children.
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11
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Parental alcohol consumption and risk of leukemia in the offspring: a systematic review and meta-analysis. Eur J Cancer Prev 2018; 26:433-441. [PMID: 28379884 DOI: 10.1097/cej.0000000000000350] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Parental alcohol consumption before and during pregnancy has been linked to adverse outcomes in the offspring including leukemogenesis. We, therefore, aimed to systematically assess and quantitatively synthesize published data on the association of paternal consumption during preconception and maternal consumption during pregnancy with leukemia risk in childhood (0-14 years). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed (until February 2016) and the reference lists of the relevant studies. Observational studies examining the association between parental alcohol consumption and childhood leukemia were considered eligible. Data extracted from 39 case-control studies (over 16 000 leukemia cases and 30 000 controls) were pooled and summary-effect estimates were calculated. Subgroup analyses were carried out by main acute leukemia type [lymphoblastic or myeloid), cytogenetics/genetic polymorphisms, and specific alcohol beverages. We found a statistically significant dose-response association of any level of maternal alcohol consumption compared with nondrinking during pregnancy exclusively with acute myeloid leukemia (AML) [odds ratio (OR)moderate consumption: 1.64, 95% confidence intervals (CIs): 1.23-2.17 and ORhigh consumption: 2.36, 95% CI: 1.60-3.49]. In contrast, no association of paternal preconception consumption with any leukemia type was noted. In beverage-specific analyses, only a positive association of maternal wine drinking with childhood AML was found, which was more pronounced in analyses including only studies on infant leukemia (ORwine: 2.12, 95% CI: 1.16-3.90). The largest ever meta-analysis shows a sizeable, statistically significant dose-response association of maternal alcohol consumption during index pregnancy with AML risk. Future research exploring the role of genetic polymorphisms is anticipated to shed light on the underlying pathophysiology.
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12
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Hill SY, Rompala G, Homanics GE, Zezza N. Cross-generational effects of alcohol dependence in humans on HRAS and TP53 methylation in offspring. Epigenomics 2017; 9:1189-1203. [PMID: 28799801 DOI: 10.2217/epi-2017-0052] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIM We hypothesized that cross-generational effects of alcohol exposure could alter DNA methylation and expression of the HRAS oncogene and TP53 tumor suppressor gene that drive cancer development. METHODS DNA methylation of the HRAS and TP53 genes was tested in samples from young participants (Mean age of 13.4 years). RESULTS Controlling for both personal use and maternal use of substances during pregnancy, familial alcohol dependence was associated with hypomethylation of CpG sites in the HRAS promoter region and hypermethylation of the TP53 gene. CONCLUSION The results suggest that ancestral exposure to alcohol can have enduring effects that impact epigenetic processes such as DNA methylation that controls expression of genes that drive cancer development such as HRAS and TP53.
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Affiliation(s)
- Shirley Y Hill
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Gregory Rompala
- Center for Neuroscience, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Gregg E Homanics
- Departments of Anesthesiology & Pharmacology & Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Nicholas Zezza
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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13
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Parental smoking, maternal alcohol, coffee and tea consumption and the risk of childhood brain tumours: the ESTELLE and ESCALE studies (SFCE, France). Cancer Causes Control 2017; 28:719-732. [PMID: 28477209 DOI: 10.1007/s10552-017-0900-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 04/25/2017] [Indexed: 12/27/2022]
Abstract
PURPOSE To investigate whether parental smoking around the time of pregnancy or maternal consumption of beverages (alcohol, coffee, or tea) during pregnancy were associated with the risk of CBT. METHODS We pooled data from two French national population-based case-control studies with similar designs conducted in 2003-2004 and 2010-2011. The mothers of 510 CBT cases (directly recruited from the national childhood cancer register) and 3,102 controls aged under 15 years, frequency matched by age and gender, were interviewed through telephone, which included questions about prenatal parental smoking and maternal consumption of alcohol, coffee and tea. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression, adjusted for age, sex and study of origin. RESULTS No association was seen between CBT and the mother smoking or drinking alcohol, coffee, or tea during the index pregnancy. The OR between CBT and paternal smoking in the year before birth (as reported by the mother) was 1.25 (95% CI 1.03, 1.52) with an OR of 1.09 (0.99, 1.19) for every 10 cigarettes per day (CPD) smoked. The association between paternal smoking and CBT appeared to be stronger in children diagnosed before the age of five years (OR 1.52, 95% CI 1.14, 2.02) and for astrocytoma (OR 1.86, 95% CI 1.26, 2.74). CONCLUSION We found some evidence of a weak association between paternal smoking in the year before the child's birth and CBT, especially astrocytomas. These findings need to be replicated in other samples, using similar classifications of tumour subtypes.
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14
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Whitehead TP, Metayer C, Wiemels JL, Singer AW, Miller MD. Childhood Leukemia and Primary Prevention. Curr Probl Pediatr Adolesc Health Care 2016; 46:317-352. [PMID: 27968954 PMCID: PMC5161115 DOI: 10.1016/j.cppeds.2016.08.004] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Leukemia is the most common pediatric cancer, affecting 3800 children per year in the United States. Its annual incidence has increased over the last decades, especially among Latinos. Although most children diagnosed with leukemia are now cured, many suffer long-term complications, and primary prevention efforts are urgently needed. The early onset of leukemia-usually before 5 years of age-and the presence at birth of "pre-leukemic" genetic signatures indicate that pre- and postnatal events are critical to the development of the disease. In contrast to most pediatric cancers, there is a growing body of literature-in the United States and internationally-that has implicated several environmental, infectious, and dietary risk factors in the etiology of childhood leukemia, mainly for acute lymphoblastic leukemia, the most common subtype. For example, exposures to pesticides, tobacco smoke, solvents, and traffic emissions have consistently demonstrated positive associations with the risk of developing childhood leukemia. In contrast, intake of vitamins and folate supplementation during the preconception period or pregnancy, breastfeeding, and exposure to routine childhood infections have been shown to reduce the risk of childhood leukemia. Some children may be especially vulnerable to these risk factors, as demonstrated by a disproportionate burden of childhood leukemia in the Latino population of California. The evidence supporting the associations between childhood leukemia and its risk factors-including pooled analyses from around the world and systematic reviews-is strong; however, the dissemination of this knowledge to clinicians has been limited. To protect children's health, it is prudent to initiate programs designed to alter exposure to well-established leukemia risk factors rather than to suspend judgment until no uncertainty remains. Primary prevention programs for childhood leukemia would also result in the significant co-benefits of reductions in other adverse health outcomes that are common in children, such as detriments to neurocognitive development.
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Affiliation(s)
- Todd P Whitehead
- Department of Epidemiology, School of Public Health, University of California, Berkeley, CA; Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA.
| | - Catherine Metayer
- Department of Epidemiology, School of Public Health, University of California, Berkeley, CA; Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA
| | - Joseph L Wiemels
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA; Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA
| | - Amanda W Singer
- Department of Epidemiology, School of Public Health, University of California, Berkeley, CA
| | - Mark D Miller
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA; Western States Pediatric Environmental Health Specialty Unit, University of California, San Francisco, CA
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15
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McBride N, Johnson S. Fathers' Role in Alcohol-Exposed Pregnancies: Systematic Review of Human Studies. Am J Prev Med 2016; 51:240-248. [PMID: 27017419 DOI: 10.1016/j.amepre.2016.02.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 01/21/2016] [Accepted: 02/08/2016] [Indexed: 02/01/2023]
Abstract
CONTEXT The role of paternal alcohol consumption on fetal and infant health outcomes, and on social facilitation of maternal alcohol consumption during pregnancy, has not been well established. This review identifies the range of impacts of paternal preconception alcohol consumption and alcohol consumption during partner's pregnancy, on maternal consumption, and fetal and infant health outcomes. EVIDENCE ACQUISITION The review accessed articles from the following databases: Scopus, Science Direct, Wiley Online, MEDLINE, ProQuest Central, PsycINFO, and Web of Science. The review included medium- and large-scale studies that provided separate paternal alcohol results, had a non-respondent rate ≤20%, an attrition rate ≤10% per year of data collection up to 30%, and were published between 1990 and 2014. The review included both randomly and non-randomly selected studies, and both case-control and non-case-control studies with notation on risk of bias. EVIDENCE SYNTHESIS Independent extraction and assessment of articles by two authors was conducted using predefined data fields, including study quality indicators, during 2015. Studies included in the review (11 studies, N=41,062) provide evidence that paternal alcohol consumption during preconception or during pregnancy has an impact on maternal health and alcohol consumption during pregnancy, fetal outcomes, and infant health outcomes. CONCLUSIONS Attention to paternal preconception health care related to alcohol consumption is an important future focus in policies dealing with reproductive, prenatal, fetal, and infant health.
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Affiliation(s)
- Nyanda McBride
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
| | - Sophia Johnson
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
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16
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Abiri B, Kelishadi R, Sadeghi H, Azizi-Soleiman F. Effects of Maternal Diet During Pregnancy on the Risk of Childhood Acute Lymphoblastic Leukemia: A Systematic Review. Nutr Cancer 2016; 68:1065-72. [PMID: 27472187 DOI: 10.1080/01635581.2016.1206581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Acute lymphoblastic leukemia (ALL) is the most common type of leukemia in children that can be affected by maternal diet. The aim of this study was to evaluate maternal dietary risk factors of ALL. We searched MEDLINE, Cochrane Library, Springer Link, Wiley Online, Science Direct, Mosby, ISI Web of Science, OVID, ProQuest, and Scopus from database inception until February 2, 2016. Two reviewers scanned titles, abstracts, and keywords of articles after excluding duplicates. We included case-control studies evaluating the relationship between maternal diet during pregnancy and childhood ALL. The search resulted in 2,940 papers, of which 11 full-text articles met the criteria for inclusion in the review and were analyzed. The finding of these studies suggest that maternal diet composed largely of vegetables, fruits, and protein sources before and during pregnancy can reduce the risk of ALL in offspring. Maternal alcohol intake had no effect. Nevertheless, inherent limitations of case-control studies like measurement error, random error, recall bias, and selection bias preclude conclusive evidence. Persuading pregnant women to follow a healthy diet rich in fruits, vegetables, and protein may reduce the risk of childhood ALL. Avoiding alcohol intake seems prudent.
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Affiliation(s)
- Behnaz Abiri
- a Department of Nutrition , School of Public Health, Iran University of Medical Sciences , Tehran , Iran
| | - Roya Kelishadi
- b Department of Pediatrics , Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences , Isfahan , Iran
| | - Homa Sadeghi
- c Institute of Public Health and Clinical Nutrition, University of Eastern Finland , Finland
| | - Fatemeh Azizi-Soleiman
- a Department of Nutrition , School of Public Health, Iran University of Medical Sciences , Tehran , Iran
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17
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Yan K, Xu X, Liu X, Wang X, Hua S, Wang C, Liu X. Corrigendum: The Associations Between Maternal Factors During Pregnancy and the Risk of Childhood Acute Lymphoblastic Leukemia: A Meta-Analysis. Pediatr Blood Cancer 2016; 63:953-4. [PMID: 26999072 DOI: 10.1002/pbc.25962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 02/02/2016] [Indexed: 12/27/2022]
Abstract
Because of the erroneous application of multiple publications, the conclusions of our recent paper (Pediatr Blood Cancer 2015;62:1162-70) were not reliable. The corrected results show that coffee drinking during pregnancy was risk factor for childhood acute lymphoblastic leukemia (OR = 1.44, 95% confidence interval = 1.07-1.92).
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Affiliation(s)
- Kangkang Yan
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xuejing Xu
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xiaodong Liu
- Key Laboratory of Radiobiology (Ministry of Health), School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xikui Wang
- Department of Statistics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shucheng Hua
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Chunpeng Wang
- School of Mathematics and Statistics, Northeast Normal University, Changchun, Jilin, China
| | - Xin Liu
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
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18
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Thomopoulos TP, Sergentanis TN, Karalexi MA, Petridou ET. Methodological Remarks Regarding the Meta-Analysis on Possible Associations of Maternal Factors During Pregnancy With the Risk of Childhood Acute Lymphoblastic Leukemia. Pediatr Blood Cancer 2016; 63:950. [PMID: 25991602 DOI: 10.1002/pbc.25584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 04/15/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Thomas P Thomopoulos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
| | - Theodoros N Sergentanis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
| | - Maria A Karalexi
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
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19
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Yan K, Xu X, Liu X, Wang X, Hua S, Wang C, Liu X. The associations between maternal factors during pregnancy and the risk of childhood acute lymphoblastic leukemia: A meta-analysis. Pediatr Blood Cancer 2015; 62:1162-70. [PMID: 25728190 DOI: 10.1002/pbc.25443] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 12/26/2014] [Indexed: 01/25/2023]
Abstract
BACKGROUND Although genetic and environmental factors are considered to be the main causes of acute lymphoblastic leukemia, the associations between maternal factors during pregnancy and the childhood ALL is still unclear. PROCEDURE In this study, meta-analysis was used. Medline, PubMed, and Web of Science were searched. The result was assessed based on pooled odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS The pooled ORs showed that there were associations between childhood ALL and the birth order (The first vs others, OR = 1.08, 95%CI = 1.00-1.16), the education of pregnant woman (>high school vs ≤ high school, OR = 0.82, 95%CI = 0.77-0.86), smoking (Ever vs never, OR = 1.10, 95%CI = 1.02-1.19). CONCLUSIONS Our meta-analysis showed that there were important associations between childhood ALL and the birth order, the education of pregnant woman, smoking.
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Affiliation(s)
- Kangkang Yan
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xuejing Xu
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xiaodong Liu
- Key Laboratory of Radiobiology (Ministry of Health), School of Public Health, Jilin University, Changchun, China
| | - Xikui Wang
- Department of Statistics, University of Manitoba, Winnipeg, Canada
| | - Shucheng Hua
- The First Hospital of Jilin University, Changchun, China
| | - Chunpeng Wang
- School of Mathematics and Statistics, Northeast Normal University, Changchun, Jilin, China
| | - Xin Liu
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
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20
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Maternal Alcohol Consumption during Pregnancy and Early Age Leukemia Risk in Brazil. BIOMED RESEARCH INTERNATIONAL 2015; 2015:732495. [PMID: 26090439 PMCID: PMC4450284 DOI: 10.1155/2015/732495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 08/06/2014] [Accepted: 08/08/2014] [Indexed: 11/17/2022]
Abstract
Objectives. To investigate the association between the maternal alcohol consumption during pregnancy and early age leukemia (EAL) in offspring. Methods. Datasets were analyzed from a case-control study carried out in Brazil during 1999-2007. Data were obtained by maternal interviews using a standardized questionnaire. The present study included 675 children (193 acute lymphoid leukemia (ALL), 59 acute myeloid leukemia (AML), and 423 controls). Unconditional logistic regression was performed, and adjusted odds ratios (adj. OR) on the association between alcohol consumption and EAL were ascertained. Results. Alcohol consumption was reported by 43% of ALL and 39% of AML case mothers and 35.5% of controls'. Beer consumption before and during pregnancy was associated with ALL in crude analysis (OR = 1.54, 95% CI, 1.08-2.19), although in adjusted analysis no statistical significance was found. For weekly intake of ≤1 glass (adj. OR = 1.30, 95% CI, 0.71-2.36) and ≥1 glass/week (adj. OR = 1.47, 95% CI, 0.88-2.46) a potential dose-response was observed (P trend < 0.03). Conclusion. This study failed to support the hypothesis of an increased risk of EAL associated with maternal alcohol intake during pregnancy, neither with the interaction with tobacco nor with alcohol consumption.
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Orsi L, Rudant J, Ajrouche R, Leverger G, Baruchel A, Nelken B, Pasquet M, Michel G, Bertrand Y, Ducassou S, Gandemer V, Lutz P, Saumet L, Moreau P, Hemon D, Clavel J. Parental smoking, maternal alcohol, coffee and tea consumption during pregnancy, and childhood acute leukemia: the ESTELLE study. Cancer Causes Control 2015; 26:1003-17. [DOI: 10.1007/s10552-015-0593-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 04/22/2015] [Indexed: 10/23/2022]
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22
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Greenop KR, Hinwood AL, Fritschi L, Scott RJ, Attia J, Ashton LJ, Heath JA, Armstrong BK, Milne E. Vehicle refuelling, use of domestic wood heaters and the risk of childhood brain tumours: Results from an Australian case-control study. Pediatr Blood Cancer 2015; 62:229-234. [PMID: 25283072 DOI: 10.1002/pbc.25268] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 08/07/2014] [Indexed: 01/02/2023]
Abstract
BACKGROUND The aetiology of childhood brain tumours (CBT) is largely unknown. Damage to germ cells after parental exposure to airborne carcinogens, such as volatile organic compounds and polycyclic aromatic hydrocarbons is one plausible pathway. This analysis aimed to investigate whether parental refuelling of vehicles or the use of domestic wood heaters in key time periods relating to the child's birth was associated with an increased risk of CBT. PROCEDURE Cases <15 years of age were recruited through 10 paediatric oncology centres around Australia; controls were recruited through nationwide random-digit dialling, frequency matched to cases on age, sex and State of residence. Exposure to refuelling and wood heaters was ascertained through questionnaires from both parents. Odds ratios (ORs) and confidence intervals (CIs) were estimated using unconditional logistic regression, adjusting for relevant covariates. RESULTS Data were available for 306 case and 950 control families. Paternal refuelling ≥4 times/month was associated with an increased risk of CBT (OR 1.59, 95% CI: 1.11, 2.29), and a dose-dependent trend was observed (P = 0.004). No association was seen for maternal refuelling. Use of closed, but not open, wood heaters before (OR 1.51, 95% CI: 1.05, 2.15) and after (OR 1.44, 95% CI: 1.03, 2.01) the child's birth was associated with increased risk of CBT, but dose-response relationships were weak or absent. CONCLUSIONS Paternal refuelling of vehicles ≥4 times/month and the use of closed wood heaters before the child's birth may increase the risk of CBT. Replication in larger studies is needed. Pediatr Blood Cancer 2015;62:229-234. © 2014 Wiley Periodicals, Inc.
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Affiliation(s)
- Kathryn R Greenop
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Andrea L Hinwood
- Centre for Ecosystem Management, Edith Cowan University, Perth, Western Australia, Australia
| | - Lin Fritschi
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Rodney J Scott
- Hunter Medical Research Institute, John Hunter Hospital, Newcastle, New South Wales, Australia.,School of Biomedical Sciences and Pharmacy, Faculty of Health, University of Newcastle, Newcastle, New South Wales, Australia.,Hunter Area Pathology Service, HNEHealth, Newcastle, New South Wales, Australia
| | - John Attia
- Hunter Medical Research Institute, John Hunter Hospital, Newcastle, New South Wales, Australia.,School of Medicine and Public Health, Faculty of Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Lesley J Ashton
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.,Research Portfolio, University of Sydney, Sydney, Australia
| | - John A Heath
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Bruce K Armstrong
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Sax Institute, Haymarket, New South Wales, Australia
| | - Elizabeth Milne
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
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Greenop KR, Miller M, Bailey HD, Scott RJ, Attia J, Bower C, van Bockxmeer FM, Ashton LJ, Armstrong BK, Milne E. Paternal Dietary Folate, B6 and B12 Intake, and the Risk of Childhood Brain Tumors. Nutr Cancer 2015; 67:224-30. [DOI: 10.1080/01635581.2015.990571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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24
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Johnson KJ, Cullen J, Barnholtz-Sloan JS, Ostrom QT, Langer CE, Turner MC, McKean-Cowdin R, Fisher JL, Lupo PJ, Partap S, Schwartzbaum JA, Scheurer ME. Childhood brain tumor epidemiology: a brain tumor epidemiology consortium review. Cancer Epidemiol Biomarkers Prev 2014; 23:2716-36. [PMID: 25192704 PMCID: PMC4257885 DOI: 10.1158/1055-9965.epi-14-0207] [Citation(s) in RCA: 222] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Childhood brain tumors are the most common pediatric solid tumor and include several histologic subtypes. Although progress has been made in improving survival rates for some subtypes, understanding of risk factors for childhood brain tumors remains limited to a few genetic syndromes and ionizing radiation to the head and neck. In this report, we review descriptive and analytical epidemiology childhood brain tumor studies from the past decade and highlight priority areas for future epidemiology investigations and methodological work that is needed to advance our understanding of childhood brain tumor causes. Specifically, we summarize the results of a review of studies published since 2004 that have analyzed incidence and survival in different international regions and that have examined potential genetic, immune system, developmental and birth characteristics, and environmental risk factors. Cancer Epidemiol Biomarkers Prev; 23(12); 2716-36. ©2014 AACR.
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Affiliation(s)
- Kimberly J Johnson
- Brown School Masters of Public Health Program, Washington University in St. Louis, St. Louis, Missouri
| | - Jennifer Cullen
- American Childhood Cancer Organization, Kensington, Maryland
| | - Jill S Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Quinn T Ostrom
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Chelsea E Langer
- Centre for Research in Environmental Epidemiology, Carrer Doctor Aiguader, Barcelona, Spain. Universitat Pompeu Fabra, Plaça de la Mercè, Barcelona, Spain. CIBER Epidemiología y Salud Pública, Carrer Casanova, Barcelona, Spain
| | - Michelle C Turner
- Centre for Research in Environmental Epidemiology, Carrer Doctor Aiguader, Barcelona, Spain. Universitat Pompeu Fabra, Plaça de la Mercè, Barcelona, Spain. CIBER Epidemiología y Salud Pública, Carrer Casanova, Barcelona, Spain. McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Roberta McKean-Cowdin
- Department of Preventive Medicine, University of Southern California, USC/Norris Comprehensive Cancer Center, Los Angeles, California
| | - James L Fisher
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas. Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Sonia Partap
- Division of Neurology, Stanford University, Palo Alto, California
| | - Judith A Schwartzbaum
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas. Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas.
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Confirmation of childhood acute lymphoblastic leukemia variants, ARID5B and IKZF1, and interaction with parental environmental exposures. PLoS One 2014; 9:e110255. [PMID: 25310577 PMCID: PMC4195717 DOI: 10.1371/journal.pone.0110255] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/08/2014] [Indexed: 11/19/2022] Open
Abstract
Genome wide association studies (GWAS) have established association of ARID5B and IKZF1 variants with childhood acute lymphoblastic leukemia (ALL). Epidemiological studies suggest that environmental factors alone appear to make a relatively minor contribution to disease risk. The polygenic nature of childhood ALL predisposition together with the timing of environmental triggers may hold vital clues for disease etiology. This study presents results from an Australian GWAS of childhood ALL cases (n = 358) and population controls (n = 1192). Furthermore, we utilised family trio (n = 204) genotypes to extend our investigation to gene-environment interaction of significant loci with parental exposures before conception, and child's sex and age. Thirteen SNPs achieved genome wide significance in the population based case/control analysis; ten annotated to ARID5B and three to IKZF1. The most significant SNPs in these regions were ARID5B rs4245595 (OR 1.63, CI 1.38-1.93, P = 2.13×10(-9)), and IKZF1 rs1110701 (OR 1.69, CI 1.42-2.02, p = 7.26×10(-9)). There was evidence of gene-environment interaction for risk genotype at IKZF1, whereby an apparently stronger genetic effect was observed if the mother took folic acid or if the father did not smoke prior to pregnancy (respective interaction P-values: 0.04, 0.05). There were no interactions of risk genotypes with age or sex (P-values >0.2). Our results evidence that interaction of genetic variants and environmental exposures may further alter risk of childhood ALL however, investigation in a larger population is required. If interaction of folic acid supplementation and IKZF1 variants holds, it may be useful to quantify folate levels prior to initiating use of folic acid supplements.
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Mezei G, Sudan M, Izraeli S, Kheifets L. Epidemiology of childhood leukemia in the presence and absence of Down syndrome. Cancer Epidemiol 2014; 38:479-89. [DOI: 10.1016/j.canep.2014.07.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 07/10/2014] [Accepted: 07/11/2014] [Indexed: 02/05/2023]
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27
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Mueller BU. Quality and safety in pediatric hematology/oncology. Pediatr Blood Cancer 2014; 61:966-9. [PMID: 24481936 DOI: 10.1002/pbc.24946] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 12/26/2013] [Indexed: 01/19/2023]
Abstract
Many principles of quality of care and patient safety are at the foundation of pediatric hematology/oncology. However, we still see too many errors, continue to have problems with communication, and the culture in many of our areas is still one of worrying about retribution when mentioning a problem. This review explores why specialists in pediatric hematology/oncology should be leaders in the field of quality and safety in healthcare.
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Affiliation(s)
- Brigitta U Mueller
- VPMA All Children's Hospital/Johns Hopkins Medicine, Petersburg, Florida
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28
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Oksuzyan S, Crespi CM, Cockburn M, Mezei G, Kheifets L. Birth weight and other perinatal factors and childhood CNS tumors: a case-control study in California. Cancer Epidemiol 2013; 37:402-9. [PMID: 23562044 DOI: 10.1016/j.canep.2013.03.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 03/05/2013] [Accepted: 03/06/2013] [Indexed: 11/17/2022]
Abstract
AIMS We conducted a large registry-based study in California to investigate the association of perinatal factors and childhood CNS tumors, with analysis by tumor subtype. METHODS We linked California cancer and birth registries to obtain information on 3308 cases and 3308 controls matched on age and sex. We examined the association of birth weight, gestational age, birth order, parental ages, maternal conditions during pregnancy, newborn abnormalities and the risk of childhood CNS tumors using conditional logistic regression, with adjustment for potential confounders. RESULTS The odds ratio (OR) per 1000 g increase in birth weight was 1.11 (95% CI: 0.99-1.24) for total childhood CNS tumors, 1.17 (95% CI: 0.97-1.42) for astrocytoma and 1.28 (95% CI: 0.90-1.83) for medulloblastoma. Compared to average-for-gestational age, large-for-gestational age infants were at increased risk of glioma (OR=1.86, 95% CI: 0.99-3.48), while small-for-gestational age infants were at increased risk of ependimoma (OR=2.64, 95% CI: 1.10-6.30). Increased risk of childhood CNS tumors was observed for 5-year increase in maternal and paternal ages (OR=1.06, 95% CI: 1.00-1.12 and 1.05, 95% CI: 1.00-1.10 respectively). Increased risk of astrocytoma was detected for 5-year increase in paternal age (OR=1.08; 95% CI: 1.00-1.16) and increased risk of glioma for maternal age ≥ 35 years old (OR=1.87; 95% CI: 1.00-3.52). Maternal genital herpes during pregnancy was associated with a pronounced increase in risk of total CNS tumors (OR=2.74; 95% CI: 1.16-6.51). Other (non-sexually transmitted) infections during pregnancy were associated with decreased risk of total CNS tumors (OR=0.28, 95% CI: 0.09-0.85). Maternal blood/immune disorders during pregnancy were linked to increased risk of CNS tumors (OR=2.28, 95% CI: 1.08-4.83) and medulloblastoma (OR=7.13, 95% CI: 0.82-61.03). Newborn CNS abnormalities were also associated with high risk of childhood CNS tumors (OR=4.08, 95% CI: 1.13-14.76). CONCLUSIONS Our results suggest that maternal genital herpes, blood and immunological disorders during pregnancy and newborn CNS abnormalities were associated with increased risk of CNS tumors. Maternal infections during pregnancy were associated with decreased risk of CNS tumors. Advanced maternal and paternal ages may be associated with a slightly increased risk of CNS tumors. Factors associated with CNS tumor subtypes varied by subtype, an indicator of different etiology for different subtypes.
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Affiliation(s)
- S Oksuzyan
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
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