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Cancer Med. 2018 Apr;7(4):1528-1536. doi: 10.1002/cam4.1414. Epub 2018 Mar 13.

A greater birthweight increases the risk of acute leukemias in Mexican children-experience from the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia (MIGICCL).

Author information

1
Health Research Coordination, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.
2
Pediatric Hematology Services, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS, Mexico City, Mexico.
3
Medical Research Unit in Clinical Epidemiology, UMAE Hospital de Pediatría CMN "Siglo XXI", IMSS, Mexico City, Mexico.
4
Hematology Services, UMAE Hospital de Pediatría, CMN "Siglo XXI", IMSS, Mexico City, Mexico.
5
Children's Hospital of Mexico, Federico Gómez, Secretaria de Salud (SS), Mexico City, Mexico.
6
Hematology Services, Instituto Nacional de Pediatría (INP), SS, Mexico City, Mexico.
7
Pediatric Hematology Services, CMN "20 de Noviembre", Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico.
8
Onco-Pediatrics Service, Hospital Juárez de México, SS, Mexico City, Mexico.
9
Oncology Services, Hospital Pediátrico "Moctezuma", Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico.
10
Pediatric Hematology Service, Hospital General de México, SSa, Mexico City, Mexico.
11
Pediatric Hematology Service, Hospital General Regional (HGR) No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" IMSS, Mexico City, Mexico.
12
Pediatric Surgery Service, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS, Mexico City, Mexico.
13
Pediatric Surgery Service, HGR No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" IMSS, Mexico City, Mexico.
14
Pediatric Hospital of Iztacalco, SSCDMX, Mexico City, Mexico.
15
Pediatric Hospital of Iztapalapa, SSCDMX, Mexico City, Mexico.
16
Servicio de Pediatría, Hospital General Zona (HGZ) No. 8 "Dr. Gilberto Flores Izquierdo" IMSS, Mexico City, Mexico.
17
Pediatric Services, Hospital Juárez del Centro, SS, Mexico City, Mexico.
18
General Hospital of Ecatepec "Las Américas", Instituto de Salud del Estado de México (ISEM), Mexico City, Mexico.
19
General Hospital "Dr. Manuel Gea González" SS, Mexico City, Mexico.
20
Pediatric Hospital "La Villa", SSCDMX, Mexico City, Mexico.
21
Pediatric Hospital "San Juan de Aragón", SSCDMX, Mexico City, Mexico.
22
Pediatric Services, HGR No. 72 "Lic. Vicente Santos Guajardo", IMSS, Mexico City, Mexico.
23
Pediatric Surgery Service, HGZ No. 32, IMSS, Mexico City, Mexico.
24
Pediatric Surgery Service, Hospital Pediátrico de Moctezuma, SSCDMX, Mexico City, Mexico.
25
Pediatric Services, Hospital Pediátrico de Tacubaya, SSCDMX, Mexico City, Mexico.
26
Pediatric ER, HGZ No. 47, IMSS, Mexico City, Mexico.
27
Pediatric Surgery Service, Hospital Regional "1° Octubre", ISSSTE, Mexico City, Mexico.
28
HGR No. 25, IMSS, Mexico City, Mexico.
29
Pediatric Services, Hospital General de Zona con Medicina Familiar (HGZMF) No. 29 IMSS, Mexico City, Mexico.
30
Pediatric Surgery Service, HGZ No. 27, IMSS, Mexico City, Mexico.
31
Oncology Services, INP, SSa, Mexico City, Mexico.
32
Delegación Regional Estado de México Oriente, IMSS, Mexico City, Mexico.
33
Molecular Biology Laboratory, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS, Mexico City, Mexico.
34
Laboratory of the Coordination of Epidemiological Surveillance and Support in Contingencies, Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología "Dr. Daniel Méndez Hernández", CMN "La Raza", IMSS, Mexico City, Mexico.
35
Medical Research Unit in Immunology and Infectology, Hospital de Infectología "Dr. Daniel Méndez Hernández", CMN "La Raza", IMSS, Mexico City, Mexico.
36
Cancer Genomics Laboratory, Instituto Nacional de Medicina Genómica, Mexico City, Mexico.
37
Medical Research Unit in Human Genetics, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS, Mexico City, Mexico.

Abstract

In Mexico, due to the high rates of diabetes, overweight, and obesity, there has also been noted an increased newborn weight, which may be contributing to the elevated incidence rate of childhood acute leukemia (AL). We conducted a case-control study in public hospitals of Mexico City aimed to know whether a greater weight at birth is associated with a higher risk of developing leukemia. We included incident cases with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) diagnosed between 2010 and 2015. Controls were frequency-matched to the cases by age, sex, and health institution. Logistic regression analysis was performed adjusting risks by child's sex, overcrowding index, birth order, and mother's age at the time of pregnancy. Adjusted odds ratios (aORs) and 95% confidence intervals were calculated. A total of 1455 cases and 1455 controls were included. An evident association between ALL and child's birthweight ≥2500 g was found (aOR 2.06; 95% CI: 1.59, 2.66) and also, in those with birthweight ≥3500 g (aOR 1.19; 95% CI: 1.00, 1.41). In AML patients with birthweight ≥2500 g and ≥3500 g, an aOR of 1.77 (95% CI: 1.07, 2.94) and 1.42 (95% CI: 1.03-1.95) was observed, respectively. No association was noticed with either type of AL and a birthweight ≥4000 g. To sum up, we found a moderate association between not having a low birthweight and an increased risk of acute leukemias. Birthweight ≥3500 g was also a risk factor for both types of leukemia. This suggests that a greater birthweight may increase the risk of acute leukemias in Mexican children.

KEYWORDS:

Birthweight; children; epidemiology; leukemia; risk factors

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