Kwan Marilyn L, Metayer Catherine, Crouse Vonda, Buffler Patricia A
Division of Research, Kaiser Permanente, Oakland, CA 94612, USA.
Am J Epidemiol. 2007 Jan 1;165(1):27-35. doi: 10.1093/aje/kwj336. Epub 2006 Oct 11.
Maternal illness and drug/medication use (prescription, over-the-counter, and illicit) during pregnancy might be related to childhood leukemia risk. These issues were evaluated using data (1995-2002) from the Northern California Childhood Leukemia Study. The authors selected 365 children under age 15 years who had been diagnosed with incident leukemia and birth certificate controls who were matched to them on age, sex, Hispanic ethnicity, and maternal race. Data on maternal illnesses and drug use from before pregnancy through breastfeeding were obtained by interview with the biologic mother and were analyzed by conditional logistic regression. Maternal history of influenza/pneumonia was associated with a statistically significant increased risk of acute lymphoblastic leukemia (ALL) in the offspring (odds ratio (OR) = 1.89, 95% confidence interval (CI): 1.24, 2.89), although the risk was nonsignificant for common ALL (OR = 1.41, 95% CI: 0.75, 2.63). A similar pattern of increased risk was found for history of sexually transmitted disease. Use of iron supplements was indicative of decreased ALL risk (OR = 0.67, 95% CI: 0.47, 0.94). Observing an increased risk of leukemia in children of mothers reporting a history of influenza/pneumonia and sexually transmitted disease around the time of pregnancy suggests that maternal infection might contribute to the etiology of leukemia. Furthermore, maternal iron supplement use may be protective against childhood leukemia.
孕期的母亲疾病及药物使用（处方药、非处方药和违禁药物）可能与儿童白血病风险有关。利用北加利福尼亚儿童白血病研究（1995 - 2002年）的数据对这些问题进行了评估。作者选取了365名15岁以下被诊断为新发白血病的儿童以及与之在年龄、性别、西班牙裔种族和母亲种族方面相匹配的出生证明对照者。通过与生物学母亲访谈获取了从怀孕前到哺乳期的母亲疾病和药物使用数据，并采用条件逻辑回归进行分析。母亲有流感/肺炎病史与后代急性淋巴细胞白血病（ALL）风险在统计学上显著增加相关（优势比（OR） = 1.89，95%置信区间（CI）：1.24，2.89），尽管对于普通ALL风险不显著（OR = 1.41，95% CI：0.75，2.63）。性传播疾病史也发现了类似的风险增加模式。使用铁补充剂表明ALL风险降低（OR = 0.67，95% CI：0.47，0.94）。观察到报告在孕期前后有流感/肺炎和性传播疾病史的母亲的孩子患白血病风险增加，提示母亲感染可能在白血病病因中起作用。此外，母亲使用铁补充剂可能对儿童白血病有预防作用。
