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Maternal and perinatal risk factors for childhood brain tumors (Sweden)

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Childhood brain tumors (CBT) include a diversity of rare neoplasms of largely unknown etiology. To assess possible maternal and perinatal risk factors for CBT according to subtype, we carried out a nested (within Swedish birth-cohorts, 1973–89) case-control study, utilizing data from the nationwide Birth Registry. We ascertained incident brain tumor cases through linkage of the nationwide Birth and Cancer Registries and randomly selected five living controls from the former, matching each case on gender and birthdate. There were 570CBT cases, including 205 low grade astrocytomas, 58 high grade astrocytomas, 93 medulloblastomas, 54 ependymomas, and 160 ‘others.’ Risks for all brain tumors combined were elevated in relation to: (i) three maternal exposures-oral contraceptives prior to conception (odds ratios [OR]=1.6, 95 percent confidence interval [CI]=1.0–2.8), use of narcotics (OR=1.3, CI=1.0–1.6), or penthrane (OR=1.5, CI=1.1–2.0) during delivery); (ii) characteristics of neonatal distress (a combined variable including low one-minute Apgar score, asphyxia [OR=1.5, CI=1.1–2.0]) or treatments for neonatal distress (use of supplemental oxygen, ventilated on mask, use of incubator, scalp vein infusion, feeding with a jejunal tube [OR=1.6, CI=0.9–2.6]); and (iii) neonatal infections (OR=2.4, CI=1.5–4.0). Higher subtype-specific risks, observed for a few risk factors, did not differ significantly from the risk estimates for all subtypes combined for the corresponding risk factors. Childhood brain tumors were not associated significantly with other maternal reproductive, lifestyle, or disease factors; perinatal pain, anesthetic medications, birth-related complications; or with birthweight, birth defects, or early neonatal diseases. These findings suggest several new leads, but only weak evidence of brain tumor subtype-specific differences.

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References

  1. Parkin DM, Stiller CA, Draper GJ, Bieber CA, Terracini B, Young YL. International Incidence of Childhood Cancer. Lyon, France: International Agency for Research on Cancer, 1988; IARC Sci. Pub. No. 87.

    Google Scholar 

  2. Ericsson JLE, Karnstrom L, Mattsson B. Childhood cancer in Sweden, 1958–1974. I. Incidence and mortality, Acta Paediatr Scand 1978; 67: 425–32.

    Google Scholar 

  3. Lannering B, Marky I, Nordlborg C. Brain tumors in childhood and adolescence in West Sweden 1970–1984, epidemiology and survival. Cancer 1990; 66: 604–9.

    Google Scholar 

  4. deNully Brown P, Hertz H, Olsen JH, et al. Incidence of childhood cancer in Denmark 1943–1984. Int J Epidemiol 1989; 18: 546–55.

    Google Scholar 

  5. Ries LAG, Miller BA, Hankey BF, Kosary CL, Harras A, Edwards BK, eds. 1994 SEER Cancer Statistics Review 1973–1991: Tables and Graphs, Bethesda MD (USA): National Cancer Institute, 1994; NIH Pub, No. 94–2789: 428–36.

    Google Scholar 

  6. Breslow NE, Langholz B. Childhood cancer incidence: geographical and temporal variations. Int J Cancer 1983; 32: 703–16.

    Google Scholar 

  7. Draper GJ, Kroll ME, Stiller CA. Childhood cancer. In: Doll R, Fraumeni JFJr, Muir CS, eds. Trends in Cancer Incidence and Mortality, Plainview, NY (USA): Cold Spring Harbor Laboratory Press, 1994: 493–517.

    Google Scholar 

  8. Blair V, Birch JM. Patterns and temporal trends in the incidence of malignant disease in children: II. Solid tumours of childhood. Eur J Cancer 1994; 30A: 1498–510.

    Google Scholar 

  9. Inskip PD, Linet MS, Heinernan EF, Etiology of brain tumors in adults. In: Armenian HK, Gordis L, Kelsey JL, Levine MM, Thacker SB, eds. Epidemiologic Reviews, Vol. 17. Baltimore, MD (USA): Johns Hopkins School of Hygiene and Public Health, 1996: 382–414.

    Google Scholar 

  10. Kuijten RR, Bunin GR, Nass CC, Meadows AT. Gestational and familial risk factors for childhood astrocytoma: Results of a case-control study. Cancer Res 1990; 50: 2608–12.

    Google Scholar 

  11. Bondy ML, Lustbader Ed, Buffler PA, Schull WJ, Hardy RJ, Strong LC. Genetic epidemiology of childhood brain tumors. Genet Epidemiol 1991; 8: 253–67.

    Google Scholar 

  12. Bunin GR, Kuitjen RR, Buckley JD, Rorke LB, Meadows AT. Relation between maternal diet and subsequent primitive neuroectodermal brain tumors in young children. N Engl J Med 1993; 329: 536–41.

    Google Scholar 

  13. Adami HO, Glimelius B, Sparen P, Holmberg L, Krusemo UB, Ponten J. Improvement in Swedish childhood and adolescent cancer survival 1960 through 1984. Acta Oncol 1992; 31: 1–10.

    Google Scholar 

  14. Mostow EN, Burne J, Connelly RR, Mulvihill JJ. Quality of life in long-term survivors of CNS tumors of childhood and adolescence. J Clin Oncol 1991; 9: 592–9.

    Google Scholar 

  15. Johnson DL, McCabe MA, Nicholson HS, et al. Quality of long-term survival in young children with medulloblastoma. J Neurosurg 1994; 80: 1004–10.

    Google Scholar 

  16. Zack M, Adami HO, Ericson A, Maternal and perinatal risk for childhood leukemia. Cancer Res 1991; 51: 3696–701.

    Google Scholar 

  17. Cnattingius S, Zack M, Ekbom A, Gunnarskog J, Linet M, Adami HO. Prenatal and neonatal risk factors for childhood lymphatic leukemia. JNCI 1995; 87: 908–14.

    Google Scholar 

  18. Ericson A, Eriksson M, Westerholm P, et al. Pregnancy outcome and social indicators in Sweden. Acta Paediatr Scand 1984; 73: 69–74.

    Google Scholar 

  19. Lunde AS, Lundeborg S, Lettenstrom GS, Thygesen L, Huebner J. The Person-number Systems of Sweden, Norway, Denmark, and Israel. Hyattsville, MD (USA): National Center for Health Statistics, 1980; DHHS Pub. No. (PHS) 80: 1358; Vital and Health Statistics, Series 2, No. 84: 5–11.

    Google Scholar 

  20. Mattson B, Rutqvist LE, Wallgren A. Undemotification of diagnosed cancer cases to the Stockholm Cancer Registry. Int J Epidemiol 1985; 14: 64–9.

    Google Scholar 

  21. National Board of Health and Welfare. Cancer Incidence in Sweden 1991. Stockholm, Sweden: NBHW, 1994.

    Google Scholar 

  22. World Health Organization. International Classification of Diseases, Seventh Revision. Geneva, Switzerland: WHO, 1957.

    Google Scholar 

  23. Rorke LB, Gilles FH, Davis RL, Becker LE. Revision of the World Health Organization Classification of Brain Tumors for childhood brain tumors. Cancer 1985; 56: 1869–86.

    Google Scholar 

  24. Zulch KG. Histological Typing of Tumors of the Central Nervous System. Geneva, Switzerland: World Health Organization, 1979.

    Google Scholar 

  25. National Board of Health and Welfare. Classification of Operations, No. 3–6. Stockholm, Sweden: NBHW, 1990.

    Google Scholar 

  26. World Health Organization. International Classification of Diseases, Eighth Revision, Geneva, Switzerland: WHO, 1967.

    Google Scholar 

  27. World Health Organization. International Classification of Diseases, Ninth Revision. Geneva, Switzerland: WHO, 1977.

    Google Scholar 

  28. Breslow NE, Day NE. Statistical Methods in Cancer Research. Vol. 1, Lyon, France: International Agency for Research on Cancer, 1980; IARC Sci. Pub. No. 32: 162–89.

    Google Scholar 

  29. Lubin JH, A computer program for the analysis of matched case-control studies. Comput Biomed Res 1981; 14: 138–43.

    Google Scholar 

  30. Lubin JH, Extensions of analytic methods for nested and population-based incident case-control studies. J Chron Dis 1986; 39: 379–88.

    Google Scholar 

  31. Gold E, Gordis L, Tonascia J, Szklo M. Increased risk of brain tumors in children exposed to barbiturates JNCI 1978; 61: 1031–4.

    Google Scholar 

  32. McCredie M, Maisonneuve P, Boyle P, Antenatal risk factors for malignant brain tumours in New South Wales children. Int J Cancer 1994; 56: 6–10.

    Google Scholar 

  33. Birch JM, Hartley AL, Teare MD, et al. The inter-regional epldemiological study of childhood cancer (IRESCC): case-control study of children with central nervous system tumours, Br J Neurosurg 1990; 4: 17–26.

    Google Scholar 

  34. Heinonen OP, Slone D, Shpairo S. Birth Defects and Drugs in Pregnancy. Littleton, MA (USA): Publishing Sciences Group, 1977.

    Google Scholar 

  35. Annegers JF, Kurland LT, Hauser WA. Brain tumors in children exposed to barbiturates. JNCI 1979; 63: 3–4.

    Google Scholar 

  36. Howe GR, Burch JD, Chiarelli AM, Risch HA, Choi BCK. An exploratory case-control study of brain tumors in children. Cancer Res 1989; 49: 4349–52.

    Google Scholar 

  37. Olsen JH, Boice JDJr, Fraumeni JFJr. Cancer in children of epileptic mothers and the possible relation to maternal anticonvulsant therapy. JNCI 1990; 81: 803–8.

    Google Scholar 

  38. Goldhaber MK, Selby JV, Hiatt RA. Quesenberry CP. Exposure to barbiturates in utero and during childhood and risk of intracrania and spinal cord tumors. Cancer Res 1990; 50: 4600–3.

    Google Scholar 

  39. Choi NW, Schuman LM, Gullen WH. Epidemiology of primary central nervous system neoplasms. II. Case control study. Am J Epidemiol 1970; 91: 467–85.

    Google Scholar 

  40. Gold E, Gordis L, Tonascia J, Szklo M. Risk factors for brain tumors in children. Am J Epidemiol 1979; 109: 309–19.

    Google Scholar 

  41. Emerson JC, Malone KE, Daling JR, Starzyk P. Childhood brain tumor risk in relation to birth characteristics. J Clin Epidemiol 1991; 44: 1159–66.

    Google Scholar 

  42. MacMahon B, Newill VA. Birth characteristics of children dying of malignant neoplasms. JNCI 1962; 28: 231–44.

    Google Scholar 

  43. Preston-Martin S, Yu MC, Benton B, Henderson BE. N-Nitroso compounds and childhood brain tumors: a case-control study. Cancer Res 1982; 42: 5240–5.

    Google Scholar 

  44. McCredie M, Maisonneuve P, Boyle P. Perinatal and early postnatal risk factors for malignant brain tumours in New South Wales children. Int J Cancer 1994; 56: 11–5.

    Google Scholar 

  45. Neutel CL, Buck C. Effect of smoking during pregnancy on the risk of cancer in children. JNCI 1971; 47: 59–63.

    Google Scholar 

  46. McKinney PA, Stiller CA. Maternal smoking during pregnancy and the risk of childhood cancer. Lancet 1986; 2: 519.

    Google Scholar 

  47. John EM, Savitz DA, Sandler DI. Prenatal exposure to parents' smoking and childhood cancer. Am J Epidemiol 1991; 133: 123–32.

    Google Scholar 

  48. Pershagen G, Ericson A, Otterblad-Olausson B. Maternal smoking in pregnancy: Does it increase the risk of childhood cancer? Int J Epidemiol 1992; 21: 1–5.

    Google Scholar 

  49. Gold EB, Leviton A, Lopez R, et al. Parental smoking and risk of childhood brain tumors. Am J Epidemiol 1993; 137: 620–8.

    Google Scholar 

  50. Salonen T, Saxen L. Risk indicators in childhood malignancies. Int J Cancer 1975; 15: 941–6.

    Google Scholar 

  51. Johnson CC, Spitz MR. Prematurity and risk of childhood cancer. JNCI 1986; 76: 359.

    Google Scholar 

  52. Napalkov NP. Prenatal and childhood exposure to carcinogenic factors. Cancer Detect Prev 1986; 9: 1–7.

    Google Scholar 

  53. Gould SJ. Ontogeny and Pbylogeny. Cambridge, MA (USA): Belknap Publishing Co., 1977.

    Google Scholar 

  54. Passingham RE. Rate of brain development in mammals including man. Brain Behav Evol 1985; 26: 167–75.

    Google Scholar 

  55. Hecht F, Hecht B. Cancer in ataxia-telangiectasia patients. Cancer Genet Cytogenet 1990; 46: 9–19.

    Google Scholar 

  56. Kuijten RR, Bunin GR. Risk factors for childhood brain tumors. Cancer Epidemiol Biomark Prev 1993; 2: 277–88.

    Google Scholar 

  57. Windham GC, Bjerkedal T, Langmark F. A population-based study of cancer incidence in twins and in children with congenital malformations or low birth weight, Norway, 1967–1980. Am J Epidemiol 1985; 121: 49–56.

    Google Scholar 

  58. Miller RW. Deaths from childhood leukemia and solid tumors among twins and other sibs in the United States, 1960–67. JNCI 1971; 46: 203–9.

    Google Scholar 

  59. Inskip PD, Harvey EB, Boice JDJr, et al. Incidence of childhood cancer in twins. Cancer Causes Control 1991; 2: 315–24.

    Google Scholar 

  60. Rodvall Y, Hrubee Z, Pershagen G, Ahlbom A, Bjurman A, Boice JDJr. Childhood cancer among Swedish twins. Cancer Causes Control 1992; 3: 527–32.

    Google Scholar 

  61. Mili F, Khoury MJ, Flanders WD, Greenberg RS. Risk of childhood cancer for infants with birth defects I. A recordlinkage study, Atlanta, Georgia, 1968–1988. Am J Epidemiol 1993; 137: 629–38.

    Google Scholar 

  62. Mili F, Lynch CF, Khoury MJ, Flanders WD, Edmonds LD. Risk of childhood cancer for infants with birth defects II. A record-linkage study, Iowa, 1983–1989. Am J Epidemiol 1993; 137: 639–44.

    Google Scholar 

  63. Seizinger BR, Rouleau GA, Ozeluis LF, et al. Genetic linkage of von Recklinghausen neurofibromatosis to the nerve growth factor receptive gene. Cell 1987; 49: 589–94

    Google Scholar 

  64. Seizinger BR, Rouleau G, Ozeluis SJ, et al. Common pathogenetic mechanisms for three tumor types in bilateral acoustic neurofibromatosis. Science 1987; 236: 317–9.

    Google Scholar 

  65. Gold EB, Leviton A, Lopez R, et al. The role of family history in risk of childhood brain tumors. Cancer 1994; 73: 1302–11.

    Google Scholar 

  66. Williams AE, Fang CT, Slamon DJ, et al. Seroprevalence and epidemiologic correlates of HTLV-I infection in US blood donors. Science 1988; 240: 643–6.

    Google Scholar 

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Linet, M.S., Gridley, G., Cnattingius, S. et al. Maternal and perinatal risk factors for childhood brain tumors (Sweden). Cancer Causes Control 7, 437–448 (1996). https://doi.org/10.1007/BF00052670

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