The risk of childhood brain tumors associated with delivery interventions: A Danish matched case-control study

Karen W Yeh; Di He; Johnni Hansen; Catherine L Carpenter; Beate Ritz; Jorn Olsen; Julia E Heck

doi:10.1016/j.canep.2021.102077

The risk of childhood brain tumors associated with delivery interventions: A Danish matched case-control study

Cancer Epidemiol. 2022 Feb:76:102077. doi: 10.1016/j.canep.2021.102077. Epub 2021 Dec 2.

Authors

Karen W Yeh¹, Di He², Johnni Hansen³, Catherine L Carpenter⁴, Beate Ritz⁵, Jorn Olsen⁶, Julia E Heck⁷

Affiliations

¹ Department of Epidemiology, Fielding School of Public Health, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095, USA. Electronic address: karenwyeh@g.ucla.edu.
² Department of Epidemiology, Fielding School of Public Health, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095, USA. Electronic address: dihe7@ucla.edu.
³ Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark. Electronic address: johnni@cancer.dk.
⁴ Department of Epidemiology, Fielding School of Public Health, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095, USA. Electronic address: ccarpenter@mednet.ucla.edu.
⁵ Department of Epidemiology, Fielding School of Public Health, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095, USA. Electronic address: britz@ucla.edu.
⁶ Department of Clinical Epidemiology, Aarhus University, Olof Palmes Alle 43-45, 8200 Aarhus N Aarhus, Denmark. Electronic address: jo@ph.au.dk.
⁷ Department of Epidemiology, Fielding School of Public Health, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095, USA; College of Health and Public Service, University of North Texas, 1155 Union Circle, Denton, TX, 76203, USA. Electronic address: julia.heck@unt.edu.

Abstract

Background: Head trauma has been associated with increased brain tumor risk in adults. Instrument assisted delivery can be a cause of head trauma in newborns. The goal of this study was to determine if instrument-assisted deliveries influenced the odds of childhood brain tumors in Denmark.

Methods: We conducted a matched case-control study of childhood (<20 years) brain tumors in Denmark born between 1978 and 2013 and diagnosed 1978-2016. A total of 1678 brain tumor cases were identified and 25 controls were matched to each case based on the child's sex and birth date (N = 40,934). Conditional logistic regression was used to estimate effects (odds ratios (OR) and 95% confidence intervals (95%CI)) for variables of interest.

Results: Compared to children birthed by spontaneous vaginal delivery, children who later developed ependymomas (N = 118) had a greater likelihood of having experienced vacuum assisted deliveries (OR=1.74, 95% CI 1.02-2.96). Forceps use was low, and declined across the study period. We did not observe an overall increase in all CNS tumors (combined) with either vacuum delivery (OR=0.99, 95% CI 0.84-1.18) or forceps delivery (OR=1.26, 95% CI 0.78-2.03).

Conclusion: Our findings suggest an association between vacuum assisted deliveries and ependymomas.

Keywords: Brain neoplasms; Cesarean section; Delivery complications; Instrument-assisted delivery; Pediatric cancer epidemiology.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Brain Neoplasms* / epidemiology
Brain Neoplasms* / etiology
Case-Control Studies
Child
Craniocerebral Trauma*
Denmark / epidemiology
Ependymoma*
Female
Humans
Infant, Newborn

Abstract

Publication types

MeSH terms

Grants and funding