Cancer
Application of a Maternal Comorbidity Index to Predict Childhood Cancer Risk: A Population-Based Case-Control Study in Denmark (1977-2013) Tobiloba Adanma Adenekan* Tobiloba Adanma Adenekan Julia Heck Cheng Yin Johnni Hansen
Background
A mother’s health conditions before and during pregnancy could have important consequences for her child’s health, including cancer development, as was observed in some prior studies.
Objectives
This study aimed to identify the impact of varying maternal comorbidities on the development of childhood cancers. This study applied an Obstetric Comorbidity Index (OCI) (Bateman, 2013) to examine maternal comorbid conditions in childhood cancer risk.
Methods
We conducted a population-based case-control study using the Danish National Patient Registry to obtain maternal health conditions and the Cancer Registry for child outcomes, at two time periods: cases (n=2578) and controls (64450) with ICD-10 diagnoses from 1994-2013, and the second population included cases (n=8339) and controls (n=208475) with ICD-8 and 10 diagnoses from 1977-2013. We estimated the risk of childhood cancer using conditional logistic regression.
Results
Multiple gestation pregnancy (OR=1.17, 95% CI 1.05, 1.30), maternal pre-existing diabetes (OR=1.68, 95% CI 1.14, 2.48), congenital heart disease (OR=2.62, 95% CI 1.13, 6.09) and previous cesarean delivery (OR=1.35, 95% CI 1.03, 1.75) showed an increased risk of childhood cancers (all types combined). In the 1977-2013 population, there was an increased risk of acute lymphocytic leukemia (ALL; OR=1.08, 95% CI 1.04, 1.13) and rhabdomyosarcoma (OR=1.13, 95% CI 1.01, 1.27) for each unit of increase on the OCI. Examining mothers that had a score of at least one in the OCI, there was a higher risk of ALL (OR=1.43, 95% CI 1.26, 1.62), non-Hodgkin lymphoma (OR=1.50, 95% CI 1.17, 1.91), Burkitt lymphoma (OR=1.71, 95% CI 1.12, 2.61), and rhabdomyosarcoma (OR=1.58, 95% CI 1.10, 2.26).
Conclusion
The results of the study show varying effects of exposure to one or more maternal comorbidities on individual pediatric cancer types, and an overall increased risk of several cancers in children with mothers who have 1 or more comorbidities.
