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Am J Epidemiol. 2019 May 20. pii: kwz118. doi: 10.1093/aje/kwz118. [Epub ahead of print]

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

Author information

1
UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania.
2
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
3
Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
4
Pennsylvania Department of Health, Harrisburg, Pennsylvania.
5
Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
6
School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.

Abstract

Infants and children are particularly vulnerable to in utero and early life exposures. Thus, a mother's exposures before and during pregnancy may have important consequences for her child's health, including cancer development. We examined whether birth certificate-derived maternal anthropometric characteristics are associated with increased risk of subsequent childhood cancer development, accounting for established maternal and infant risk factors. Pennsylvania birth and cancer registry files were linked by the state Department of Health, yielding a virtual cohort of births and childhood cancers from 2003 through 2016. The analysis included 1,827,875 infants (13,785,309 person-years at risk), with 2,352 children diagnosed with any cancer and 747 with leukemia before age 14. Children born to mothers with a body mass index ≥40 kg/m2 had 57% (12-120%) higher leukemia risk. Newborn size 30% higher than expected was associated with 2.2-fold and 1.8-fold hazard ratio for total childhood cancer and leukemia, respectively, relative to those with expected size. Being <30% of one's expected size also increased the total cancer risk (Pcurvilinearity<0.0001). Newborn size did not mediate the association between maternal obesity and childhood cancer. The results suggest a significant role of early life exposure to maternal obesity- and fetal growth-related factors in childhood cancer development.

KEYWORDS:

Maternal exposure; birth weight; cohort studies; leukemia; obesity

PMID:
31107539
DOI:
10.1093/aje/kwz118

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