Tettamanti Giorgio, Ljung Rickard, Mathiesen Tiit, Schwartzbaum Judith, Feychting Maria
Institute of Environmental Medicine, Unit of Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Institute of Environmental Medicine, Unit of Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Cancer Epidemiol. 2016 Feb;40:67-72. doi: 10.1016/j.canep.2015.11.009. Epub 2015 Dec 8.
Tobacco metabolites and carcinogens can be found in placental and umbilical cord tissues of fetuses exposed to maternal smoking. However, studies regarding maternal smoking during pregnancy and childhood brain tumor (CBT) have shown inconsistent results.
All children born in Sweden between 1983 and 2010 and with information about maternal smoking during pregnancy, obtained from the Swedish Medical Birth Register, were included in this population based cohort study (n=2,577,305). CBT cases were identified from the National Cancer Register. Cox regression models were used to estimate the effect of maternal smoking during pregnancy on the risk of CBTs.
We identified 1039 cases of CBT in the cohort. Overall, there was little or no effect of maternal smoking during pregnancy on the risk of CBTs. However, in analyses stratified by age at diagnosis and child's sex, positive associations were found among 5-9 years old children. In this age interval, maternal smoking during pregnancy was associated with an increased risk of all CBTs combined only among male children (RR=1.50, 95% CI 0.96-2.34), while for astrocytoma there was a positive association in both male (RR=2.00, 95% CI 1.02-3.91) and female children (RR=1.80, 95% CI 0.85-3.82).
Results from this large Swedish cohort study suggest that even though maternal smoking during pregnancy has a limited overall effect on CBTs, it may increase the risk of astrocytomas.
在暴露于母亲吸烟环境的胎儿的胎盘和脐带组织中可发现烟草代谢物和致癌物。然而，关于孕期母亲吸烟与儿童脑肿瘤（CBT）的研究结果并不一致。
本基于人群的队列研究纳入了1983年至2010年在瑞典出生且有孕期母亲吸烟信息的所有儿童（n = 2,577,305），这些信息来自瑞典医学出生登记册。CBT病例从国家癌症登记册中识别。采用Cox回归模型估计孕期母亲吸烟对CBT风险的影响。
我们在队列中识别出1039例CBT病例。总体而言，孕期母亲吸烟对CBT风险几乎没有影响。然而，在按诊断年龄和儿童性别分层的分析中，在5至9岁的儿童中发现了正相关。在这个年龄区间，孕期母亲吸烟仅在男童中与所有CBT合并风险增加相关（RR = 1.50，95%CI 0.96 - 2.34），而对于星形细胞瘤，在男童（RR = 2.00，95%CI 1.02 - 3.91）和女童（RR = 1.80，95%CI 0.85 - 3.82）中均存在正相关。
这项大型瑞典队列研究的结果表明，尽管孕期母亲吸烟对CBT的总体影响有限，但可能会增加星形细胞瘤的风险。
