Prenatal and perinatal risk factors for solid childhood malignancies: A questionnaire-based study

Sihui Li; Siyu Cai; Cheng Huang; Xi Chai; Xindi Wang; Xisi Wang; Wen Zhao; Xiaolu Nie; Xiaoxia Peng; Xiaoli Ma

doi:10.1002/ped4.12039

Prenatal and perinatal risk factors for solid childhood malignancies: A questionnaire-based study

Pediatr Investig. 2018 Jul 16;2(2):107-113. doi: 10.1002/ped4.12039. eCollection 2018 Jun.

Authors

Sihui Li¹, Siyu Cai², Cheng Huang¹, Xi Chai¹, Xindi Wang¹, Xisi Wang¹, Wen Zhao¹, Xiaolu Nie², Xiaoxia Peng², Xiaoli Ma¹

Affiliations

¹ Beijing Key Laboratory of Pediatric Hematology Oncology National Discipline of Pediatrics Ministry of Education MOE Key Laboratory of Major Diseases in Children Hematology Oncology Center Beijing Children's Hospital Capital Medical University National Center for Children's Health Beijing China.
² National Center for Clinical Epidemiology and Evidence-based Medicine Beijing Children's Hospital Capital Medical University National Center for Children's Health Beijing China.

Abstract

Importance: Childhood solid tumors account for the highest proportion of childhood cancers and are one of the leading causes of death in childhood. However, their pathogenesis is unclear.

Objective: To explore prenatal and perinatal risk factors for solid malignancies in children.

Methods: We enrolled 71 consecutive pediatric patients (44 boys and 27 girls; median age, 30 months) with solid tumors who were diagnosed and treated at our center from January 2013 to December 2016 as the case group. We also enrolled 211 age- and residence-matched healthy children (ratio of approximately 3:1 with the case group) as the control group. We conducted a questionnaire-based survey with the parents of these 282 children. Univariate and multivariate conditional logistic regression analyses of the collected data were performed.

Results: Confirmed solid malignancies included neuroblastoma (n = 32), rhabdomyosarcoma (n = 18), retinoblastoma (n = 7), renal tumors (n = 3), and other tumors (n = 11). Risk factors for solid childhood tumors in the univariate analysis were the parents' age, gravidity, parity, abortion history, vaginal bleeding, family history of malignancy, and prenatal use of folic acid or hematinics/iron supplements (P < 0.05), and those in the multivariate analysis were higher parity (odds ratio [OR], 2.482; 95% confidence interval [CI], 1.521-4.048), family history of malignancy (OR, 3.667; 95% CI, 1.679-8.009), and prenatal use of hematinics/iron supplements (OR, 2.882; 95% CI, 1.440-5.767). In contrast, use of prenatal folic acid was protective (OR, 0.334; 95% CI, 0.160-0.694).

Interpretation: A family history of malignancy, use of prenatal hematinics/iron supplements, and higher parity are risk factors for solid childhood tumors, whereas use of prenatal folic acid is a protective factor.

Keywords: Case‐control study; Children; Maternal; Perinatal; Risk factors; Solid malignancies.