Birth weight and other perinatal factors and childhood CNS tumors: A case–control study in California

• Published in: Cancer epidemiology 2013-08, Vol.37 (4), p.402-409
• Main Authors: Oksuzyan, S, Crespi, C.M, Cockburn, M, Mezei, G, Kheifets, L
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Age Factors; Analysis. Health state; Banking industry; Biological and medical sciences; Birth order; Birth Weight; Brain cancer; California - epidemiology; Cancer; Case-Control Studies; Central Nervous System - abnormalities; Central Nervous System Neoplasms - epidemiology; Central Nervous System Neoplasms - pathology; Child; Child, Preschool; Childhood brain tumors; Childhood CNS tumors; Conferences; Epidemiology; Female; General aspects; Hematology, Oncology and Palliative Medicine; Humans; Infant; Infant, Newborn; Internal Medicine; Logistic Models; Male; Maternal Age; Medical sciences; Newborn abnormalities; Older people; Parental age; Paternal Age; Perinatal factors; Pregnancy; Pregnancy complications; Pregnancy Complications - epidemiology; Pregnancy Complications - physiopathology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Registries; Risk Factors; Studies; Tumors; Young Adult
• ISSN: 1877-7821; 1877-783X
• DOI: 10.1016/j.canep.2013.03.007

Abstract Aims We conducted a large registry-based study in California to investigate the association of perinatal factors and childhood CNS tumors, with analysis by tumor subtype. Methods We linked California cancer and birth registries to obtain information on 3308 cases and 3308 controls matched on age and sex. We examined the association of birth weight, gestational age, birth order, parental ages, maternal conditions during pregnancy, newborn abnormalities and the risk of childhood CNS tumors using conditional logistic regression, with adjustment for potential confounders. Results The odds ratio (OR) per 1000 g increase in birth weight was 1.11 (95% CI: 0.99–1.24) for total childhood CNS tumors, 1.17 (95% CI: 0.97–1.42) for astrocytoma and 1.28 (95% CI: 0.90–1.83) for medulloblastoma. Compared to average-for-gestational age, large-for-gestational age infants were at increased risk of glioma (OR = 1.86, 95% CI: 0.99–3.48), while small-for-gestational age infants were at increased risk of ependimoma (OR = 2.64, 95% CI: 1.10–6.30). Increased risk of childhood CNS tumors was observed for 5-year increase in maternal and paternal ages (OR = 1.06, 95% CI: 1.00–1.12 and 1.05, 95% CI: 1.00–1.10 respectively). Increased risk of astrocytoma was detected for 5-year increase in paternal age (OR = 1.08; 95% CI: 1.00–1.16) and increased risk of glioma for maternal age ≥ 35 years old (OR = 1.87; 95% CI: 1.00–3.52). Maternal genital herpes during pregnancy was associated with a pronounced increase in risk of total CNS tumors (OR = 2.74; 95% CI: 1.16–6.51). Other (non-sexually transmitted) infections during pregnancy were associated with decreased risk of total CNS tumors (OR = 0.28, 95% CI: 0.09–0.85). Maternal blood/immune disorders during pregnancy were linked to increased risk of CNS tumors (OR = 2.28, 95% CI: 1.08–4.83) and medulloblastoma (OR = 7.13, 95% CI: 0.82–61.03). Newborn CNS abnormalities were also associated with high risk of childhood CNS tumors (OR = 4.08, 95% CI: 1.13–14.76). Conclusions Our results suggest that maternal genital herpes, blood and immunological disorders during pregnancy and newborn CNS abnormalities were associated with increased risk of CNS tumors. Maternal infections during pregnancy were associated with decreased risk of CNS tumors. Advanced maternal and paternal ages may be associated with a slightly increased risk of CNS tumors. Factors associated with CNS tumor subtypes varied by subtype, an indicator of different etiology for di