Mode of delivery and the risk of lymphoblastic leukemia during childhood-A Swedish population-based cohort study.

IF 5.7 2区 医学 Q1 ONCOLOGY
Christina-Evmorfia Kampitsi, Hanna Mogensen, Mats Heyman, Maria Feychting, Giorgio Tettamanti
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引用次数: 0

Abstract

Cesarean section (CS) rates have been increasing beyond medically warranted thresholds, despite potential long-term adverse outcomes. Previous research on CS delivery and childhood leukemia is conflicting but suggests an increased acute lymphoblastic leukemia (ALL) risk in children delivered by planned CS. It has been suggested that maternal and pregnancy conditions predisposing to pregnancy complications might confound such an association; therefore, we aimed to elucidate the relationship between delivery mode and ALL in Swedish children. To this end, we studied all children born in Sweden between 1982-1989 and 1999-2014, when comprehensive information on delivery mode was available (n = 2,442,330). Pregnancy conditions, delivery mode, and childhood ALL diagnoses (<20 years) were retrieved from nationwide registers. Cox proportional hazards regression was used to assess the association between delivery mode and childhood ALL, adjusting for maternal and pregnancy conditions. We observed an increased ALL risk among children delivered by planned CS (HR = 1.21, 95% CI 0.96-1.54), driven by B-cell precursor ALL (HR = 1.29, 95% CI 1.01-1.67). The associations were concentrated among boys and at peak ages of ALL incidence (≤5 years) and persisted after accounting for potential confounders, including maternal and perinatal factors. Unplanned CS was not associated with increased risk of childhood ALL. Our nationwide study supports an association between planned CS and an increased B-cell precursor ALL risk in Swedish children, irrespective of maternal and pregnancy conditions. Possible underlying mechanisms, such as lack of exposure to maternal vaginal microbiota or decreased stress hormones at birth, require further exploration.

儿童时期的分娩方式和淋巴细胞白血病的风险——一项瑞典人群队列研究。
尽管存在潜在的长期不良后果,剖宫产(CS)率已经超过了医学上允许的阈值。先前关于CS分娩和儿童白血病的研究是相互矛盾的,但表明计划CS分娩的儿童急性淋巴细胞白血病(ALL)风险增加。有人认为,易患妊娠并发症的产妇和妊娠条件可能会混淆这种关联;因此,我们旨在阐明分娩方式与瑞典儿童ALL之间的关系。为此,我们研究了1982-1989年和1999-2014年期间在瑞典出生的所有儿童,当时有关于分娩方式的全面信息(n = 2,442,330)。妊娠情况、分娩方式和儿童ALL诊断(
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来源期刊
CiteScore
13.40
自引率
3.10%
发文量
460
审稿时长
2 months
期刊介绍: The International Journal of Cancer (IJC) is the official journal of the Union for International Cancer Control—UICC; it appears twice a month. IJC invites submission of manuscripts under a broad scope of topics relevant to experimental and clinical cancer research and publishes original Research Articles and Short Reports under the following categories: -Cancer Epidemiology- Cancer Genetics and Epigenetics- Infectious Causes of Cancer- Innovative Tools and Methods- Molecular Cancer Biology- Tumor Immunology and Microenvironment- Tumor Markers and Signatures- Cancer Therapy and Prevention
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