Maternal smoking during pregnancy and childhood cancer in New South Wales: A record linkage investigation
Monitoring Evaluation and Research Unit, Cancer Institute NSW, P.O. Box 41, Alexandria, NSW, 1435, Australia. Cancer Causes and Control
(Impact Factor: 2.74).
08/2009; 20(9):1551-8. DOI: 10.1007/s10552-009-9400-5
Following linkage between the NSW Central Cancer Registry (CCR) and the NSW Midwives Data Collection, an investigation of the association between maternal smoking during pregnancy and the risk of childhood cancer in their offspring was undertaken. Children born in NSW between 1994 and 2005, inclusive of 1,045,966 babies, were matched to 948 cancer cases in the CCR. After adjustment for maternal age, gestational age, baby's gender, birth weight, remoteness index, socioeconomic disadvantage and maternal health factors, no association (OR = 0.96, 95% CI 0.81-1.15, p = 0.68) was found with childhood cancer between mothers who smoked (81/100,000) and those who did not smoke during pregnancy (99/100,000). Maternal smoking was, however, significantly associated with retinoblastoma (OR = 2.20, 95% CI 1.19-4.09, p = 0.01). Association between maternal smoking and preterm birth and low birth weight was significant. Maternal smoking during pregnancy is significantly associated with retinoblastoma and adverse birth outcomes. These results should be highlighted to expectant mothers through antitobacco-smoking campaigns.
Available from: Petra Otterblad Olausson
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ABSTRACT: Studies conducted so far have found no statistically significant increased risk for cancer among children who are born after in vitro fertilization (IVF).
We followed 26,692 children who were born after IVF during the years 1982-2005 by using the Swedish Cancer Register and compared the number of children who had cancer and were born after IVF with children who were not conceived by IVF. Adjustment was made for year of birth.
Maternal age, parity, smoking, subfertility, previous miscarriages, BMI, and multiple births did not significantly affect cancer risk in offspring. High birth weight, premature delivery, and the presence of respiratory diagnoses and low Apgar score were risk factors for cancer. We identified 53 cases of cancer in children who were born after IVF against 38 expected cases: 18 of them with hematologic cancer (15 of them acute lymphoblastic leukemia), 17 with eye or central nervous system tumors, and 12 with other solid cancers. There were 6 cases of Langerhans histiocytosis against 1.0 expected. The total cancer risk estimate was 1.42 (95% confidence interval: 1.09-1.87).
We found a moderately increased risk for cancer in children who were conceived by IVF. Putative intermediary factors could be preterm birth and neonatal asphyxia.
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ABSTRACT: Social gradients in Aboriginal health are seldom explored. This study describes social gradients and trends in smoking during pregnancy among Aboriginal mothers in NSW.
This was a secondary analysis of the NSW Midwives Data Collection (MDC) 1994-2007, covering all births in NSW. Analyses examined associations between socio-demographic characteristics and smoking during pregnancy.
Data from 1,214,206 pregnant women showed that 17.4% smoked during pregnancy. The rate of smoking during pregnancy among all NSW women declined from 22.3% in 1994 to 12.8% in 2007; the rate among Aboriginal women remained high, declining from 61.4% in 1994 to 50.2% in 2007. Smoking was substantially higher among Aboriginal mothers compared to non-Aboriginal mothers. Socio-economic analyses showed that the smoking rate among low SES Aboriginal mothers was approximately two and a half times that of high SES Aboriginal women, a similar gradient to non-Aboriginal women.
Indicators of socio-economic position are a consistent, independent correlate of smoking during pregnancy for Aboriginal and non-Aboriginal women.
There is a need for a social inequalities approach to smoking during pregnancy, specifically targeting more disadvantaged Aboriginal mothers and all teenage mothers for smoking prevention. Strategies to access more disadvantaged mothers should not be missed through broadly focused Aboriginal tobacco control strategies.
Available from: Apostolos Pourtsidis
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ABSTRACT: Results from epidemiological studies exploring the association between childhood lymphoma and maternal smoking during pregnancy have been contradictory. This meta-analysis included all published cohort (n = 2) and case–control (n = 10) articles; among the latter, the data of the Greek Nationwide Registry for Childhood Hematological Malignancies study were updated to include all recently available cases (-2008). Odds ratios (ORs), relative risks and hazard ratios were appropriately pooled in three separate analyses concerning non-Hodgkin lymphoma (NHL, n = 1,072 cases), Hodgkin lymphoma (HL, n = 538 cases) and any lymphoma (n = 1,591 cases), according to data availability in the included studies. An additional metaregression analysis was conducted to explore dose–response relationships. A statistically significant association between maternal smoking (any vs. no) during pregnancy and risk for childhood NHL was observed (OR = 1.22, 95% confidence interval, CI: 1.03–1.45, fixed effects model), whereas the risk for childhood HL was not statistically significant (OR = 0.90, 95% CI: 0.66–1.21, fixed effects model). The analysis on any lymphoma did not reach statistical significance (OR = 1.10, 95% CI = 0.96–1.27, fixed effects model), possibly because of the case-mix of NHL to HL. No dose–response association was revealed in the metaregression analysis. In conclusion, this meta-analysis points to a modest increase in the risk for childhood NHL, but not HL, among children born by mothers smoking during pregnancy. Further investigation of dose–response phenomena in the NHL association, however, warrants accumulation of additional data.
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