Maternal lifestyle factors and risk of neuroblastoma in the offspring: A meta-analysis including Greek NARECHEM-ST primary data

• Published in: Cancer epidemiology 2022-04, Vol.77, p.102055-102055, Article 102055
• Main Authors: Karalexi, Maria A, Katsimpris, Andreas, Panagopoulou, Paraskevi, Bouka, Panagiota, Schüz, Joachim, Ntzani, Evangelia, Petridou, Eleni Th, Servitzoglou, Marina, Baka, Margarita, Moschovi, Maria, Kourti, Maria, Papadakis, Vassilios, Polychronopoulou, Sofia, Hatzipantelis, Emmanouel, Ioannidou, Maria, Dana, Helen, Pelagiadis, Iordanis, Stiakaki, Eftichia, Stefanaki, Kalliopi, Strantzia, Katerina, Gavra, Maro, Malama, Astero, Mitsios, Andreas, Bouka, Evdoxia
• Format: Article
• Language: English
• Subjects: Alcohol; Algorithms; Cancer; Case-Control Studies; Children; Confidence intervals; Dietary supplements; Epidemiology; Etiology; Female; Greece - epidemiology; Hematologic Neoplasms; Hematology; Hospitalization; Humans; Life Style; Lifestyle factors; Lifestyles; Longitudinal studies; Meta-analysis; Neuroblastoma; Neuroblastoma - epidemiology; Neuroblastoma - etiology; Offspring; Pediatrics; Pregnancy; Questionnaires; Registries; Risk analysis; Risk Factors; Smoking; Sociodemographics; Solid tumors; Systematic review; Tumors; Vitamins
• ISSN: 1877-7821; 1877-783X
• DOI: 10.1016/j.canep.2021.102055

The etiology of childhood neuroblastoma remains largely unknown. In this systematic review and meta-analysis, we summarized and quantitatively synthesized published evidence on the association of maternal modifiable lifestyle factors with neuroblastoma risk in the offspring. We searched MEDLINE up to December 31, 2020 for eligible studies assessing the association of maternal smoking, alcohol consumption and nutritional supplementation during pregnancy with childhood (0–14 years) neuroblastoma risk. Random-effects models were run, and summary odds ratios (OR) and 95% confidence intervals (95% CI) on the relevant associations were calculated, including estimates derived from primary data (n = 103 cases and n = 103 controls) of the Nationwide Registry for Childhood Hematological Malignancies and Solid Tumors (NARECHEM-ST) case control study (2009–2017) in Greece. Twenty-one eligible studies amounting 5163 cases participating in both case-control and cohort/linkage studies were included in the meta-analysis. Maternal smoking and alcohol consumption were not statistically significantly associated with neuroblastoma risk (summary ORsmoking: 1.08, 95% CI: 0.96–1.22, I2 =12.0%, n = 17 studies; summary ORalcohol: 1.01, 95% CI: 0.82–1.18, I2 =0.0%, n = 8 studies). By contrast, maternal vitamin intake during pregnancy was associated with significantly lower neuroblastoma risk (summary OR: 0.57, 95% CI: 0.34–0.95, I2 =58.9%, n = 4 studies). The results of the largest to-date meta-analysis point to an inverse association between vitamin intake during pregnancy and childhood neuroblastoma risk. Future longitudinal studies are needed to confirm and further specify these associations as to guide preventive efforts on modifiable maternal risk factors of childhood neuroblastoma. •An inverse association was found between vitamin intake during pregnancy and neuroblastoma risk.•There is also evidence for a modest positive association with maternal smoking during pregnancy.•Ongoing research is needed to guide preventive efforts on modifiable risk factors of neuroblastoma.